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DOI: 10.1055/a-1784-6160
Screening auf Gestationsdiabetes mellitus (GDM) – Welchen Weg weisen die neuen Studien? Übersicht und Kommentar
Screening on Gestational Diabetes Mellitus (GDM) – Which Way Do the New Studies Show? Review and Comment![](https://www.thieme-connect.de/media/ds/202203/lookinside/thumbnails/dus-0143_10-1055-a-1784-6160-1.jpg)
Zusammenfassung
Das Screening auf Gestationsdiabetes mellitus (GDM) wird international nicht einheitlich durchgeführt. In Deutschland wird allen Schwangeren ein zweizeitiges Screening angeboten, zunächst ein 50-g Vortest (nicht nüchtern), im positiven Fall gefolgt von einem 75-g oralen Gluksetoleranztest (oGTT) über 2 h (nüchtern). Im Jahr 2021 sind zwei randomisierte Screeningstudien publiziert worden, in denen einzeitiges Screenen ohne Vortest mit dem zweizeitigen Screenen verglichen wurde. Einzeitiges Screenen erhöht die GDM-Prävalenz um das 2,3-fache ohne Vorteile für klinisch relevante Endpunkte von Müttern und Neugeborenen und um den Preis unnötiger Pharmakotherapie sowie Belastung der Ressourcen bei den Betreuern. Beim zweizeitigen Screening benötigen nur 20% der Frauen einen oGTT. Darüber hinaus wird die zweizeitige Strategie von den Frauen präferiert.
Abstract
Screening for gestational diabetes mellitus (GDM) is not carried out uniformly internationally. In Germany, all pregnant women are offered a two-stage screening, initially a 50-g pretest (not fasting), in the positive case followed by a 75-g oral glucose tolerance test (oGTT) over 2 hours (fasting). In 2021, two randomized screening studies were published in which one-stage screening without a pre-test was compared with two-stage screening. One-stage screening increases GDM prevalence 2.3-fold with no benefit for clinically relevant maternal and neonatal endpoints and at the cost of unnecessary pharmacotherapy and burden on caregiver resources. With two-stage screening, only 20% of women need an oGTT. In addition, women prefer the two-stage strategy.
Schlüsselwörter
Schwangerschaft - Glukosestoffwechsel - Diagnose - Randomisierte Studien - MetaanalysePublikationsverlauf
Eingereicht: 01. Dezember 2021
Angenommen nach Revision: 21. Februar 2022
Artikel online veröffentlicht:
09. Juni 2022
© 2022. Thieme. All rights reserved.
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