{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:54:31Z","timestamp":1790384071133,"version":"4.1.0"},"reference-count":30,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2018,5,20]]},"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Despite the\u00a0short-term and long-term health implications of gestational diabetes mellitus (GDM), opinions are divided on selective vis-\u00e0-vis universal screening. We validated the\u00a0accuracy of screening tests for GDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design and methods<\/jats:title>\n                    <jats:p>Pregnant women (n=491) were recruited to this prospective,\u00a0blind\u00a0comparison\u00a0with\u00a0a\u00a0gold\u00a0standard study. We did selective screening between 13\u00a0and\u00a020 weeks using reagent-strip glycosuria, random capillary blood glucose (RBG) and the\u00a0presence of \u22651 risk factor(s). Between 20\u00a0and\u00a034 weeks, we did universal screening following the \u2018one-step\u2019 approach using glycated hemoglobin (HbA1c), fasting venous plasma glucose (FPG), and the\u00a01-hour and the \u2018gold standard\u2019\u00a02-hour oral glucose tolerance test (OGTT). Tests accuracy was estimated following the\u00a0WHO and the National Institute\u00a0for Health and Care Excellence (NICE) diagnostic criteria. Overall test performance was determined from the area under the receiver operating characteristic curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>GDM prevalence per 2-hour OGTT was 9.0% for the\u00a0WHO criteria and 14.3% for the\u00a0NICE criteria. Selective screening using glycosuria, RBG and risk factors missed 97.4%, 87.2% and 45.7% of\u00a0cases, respectively. FPG threshold \u22655.1 mmol\/L had the highest clinically relevant sensitivity (68%) and specificity (81%), but FPG threshold \u22655.6 mmol\/L had higher positive predictive value. Although sensitivity of 1-hour OGTT was\u00a039.5%, it had the highest accuracy and diagnostic OR. Regarding test performance, 1-hour OGTT and FPG were very good (AUC&gt;0.8), RBG was poor (AUC\u22480.60), whereas HbA1c was invaluable (AUC&lt;0.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Selective screening using glycosuria\u00a0and random blood glucose is unnecessary due to its low sensitivity. Fasting glucose \u22655.1 mmol\/L could be applicable for screening at the population level. Where 2-hour OGTT is not\u00a0available, FPG\u00a0\u22655.6 mmol\/L, complemented by the\u00a0presence of risk factors, could be useful in\u00a0making therapeutic decision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjdrc-2017-000493","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T04:55:34Z","timestamp":1529038534000},"page":"e000493","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Accuracy of glycosuria, random blood glucose and risk factors as selective screening tools for gestational diabetes mellitus in comparison with universal diagnosing"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7707-5658","authenticated-orcid":false,"given":"Faith","family":"Agbozo","sequence":"first","affiliation":[{"name":"Institute of Public Health, University of Heidelberg, Heidelberg, Germany"},{"name":"Department of Family and Community Health, University of Health and Allied Health Sciences, Ho, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulai","family":"Abubakari","sequence":"additional","affiliation":[{"name":"Department of Community Nutrition, University for Development Studies, Tamale, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Narh","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of Health and Allied Health Sciences, Ho, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albrecht","family":"Jahn","sequence":"additional","affiliation":[{"name":"Institute of Public Health, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,6,15]]},"reference":[{"key":"2025073111561485000_6.1.e000493.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"2025073111561485000_6.1.e000493.2","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2393-12-23","article-title":"Gestational diabetes and pregnancy outcomes--a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria","volume":"12","author":"Wendland","year":"2012","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025073111561485000_6.1.e000493.3","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1007\/s00125-016-3985-5","article-title":"Gestational diabetes mellitus and long-term consequences for mother and offspring: a view from Denmark","volume":"59","author":"Damm","year":"2016","journal-title":"Diabetologia"},{"key":"2025073111561485000_6.1.e000493.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.11.003"},{"key":"2025073111561485000_6.1.e000493.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0097871","article-title":"Gestational diabetes mellitus in Africa: a systematic review","volume":"9","author":"Macaulay","year":"2014","journal-title":"PLoS One"},{"key":"2025073111561485000_6.1.e000493.6","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-11-564","article-title":"Diabetes in Sub Saharan Africa 1999-2011: epidemiology and public health implications. 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