GDM Screening

Bruner, similar to Seton, has made the decision to begin universal screening for diabetes early in pregnancy. In order to accomplish this, we are asking all providers to adhere to the following guidelines:

• Order a hemoglobin A1c for all patients <24 weeks EGA at their initial prenatal visit as part of their prenatal labs (please order a 1-hour GTT for all patients presenting at or beyond 24 weeks gestation)

• For patients with an A1c of 6.5 or greater, please transfer prenatal care to Seton (as this is consistent with pre-existing diabetes)

• For patients with an A1c of 5.9 to 6.4, place a referral to diabetes education and our dietician, and order a standard 1-hour GTT at 24-28 weeks gestation

• For patients with an A1c <5.9, please order the standard 1-hour GTT at 24-28 weeks gestation

The decision to transition to this screening strategy is based upon the article below, as well as to standardize testing for our patients (some attendings prefer an early A1c versus a 1-hour GTT, which becomes confusing for residents).

Updated 6/5/2025