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August 14, 1996

Should We Screen for Gestational Diabetes?

Author Affiliations

Great Plains Family Practice Residency Program Oklahoma City, Okla

JAMA. 1996;276(6):451. doi:10.1001/jama.1996.03540060027025

To the Editor.  —The article on gestational diabetes mellitus (GDM) by Dr Naylor and colleagues1 provides interesting information and will certainly add to the debate regarding the diagnosis and management of this entity. However, I would like to clarify a point in the article.The authors state that "North American guidelines recommend routine screening for GDM," and they cite references, but other authorities question this recommendation. Stephenson2 has reviewed the topic and found insufficient evidence for routine screening. In 1986,3 the American College of Obstetricians and Gynecologists recommended selective screening, but in 1994,4 they noted the absence of data to support screening and did not make a specific recommendation. Finally, the recently released guidelines from the United States Preventive Services Task Force5 cite insufficient evidence for or against screening for GDM.Given the lack of evidence that screening for or treating GDM provides any real