Tag: guidelines

When BC changed gestational diabetes screening cut-offs in 2010, did this improve health for birthing people or infants?

New research out July 2025 in Diabetes Care.

In 2010, BC moved to different cut-offs that would identify more people with gestational diabetes. My previous work found that this roughly doubled the frequency of gestational diabetes (https://globalnews.ca/news/9564044/gestational-diabetes-pregnancy-canada-study/) in BC.

The goal of the 2010 change was to improve maternal-infant birth outcomes by identifying a wider set of pregnancies that would benefit from additional monitoring and care.

In this new paper, we found that the guideline change did not improve outcomes. This analysis was considered as critical information to inform a recent (February 2024) guideline change in BC to go back to higher cut-offs and line up with the rest of Canada. 

Because gestational diabetes diagnosis guidelines are hotly debated – and affect a LOT of pregnant individuals, we think these findings are of huge interest to the public.

Is it safe to decline gestational diabetes screening when under midwifery care?

https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.15098

Check out our new study on the most commonly declined routine test in pregnancy – gestational diabetes screening!

We looked at birth outcomes in British Columbia, Canada following nonadherence to screening for gestational diabetes (GDM).

➡️ Gestational diabetes screening is routinely recommended in pregnancy, but some people experience side effects (nausea, fainting) and may choose to decline the test, especially if they are at low risk.
➡️ If high blood sugar in pregnancy (GDM) is not treated, it can lead to a baby growing “too big” so we thought we might find more big babies in those who did not screen.
➡️We included pregnant folks who had midwifery care and outcomes for people with no screening and who screened with an “alternate” test.

What did we find?
📣 Not screening for GDM did NOT increase risks of “big babies” but did increase risks for stillbirth and having a smaller than expected baby, particularly for those who had risk factors for diabetes.

Take-home:
📣 This can be used to inform shared-decision making conversations during pregnancy about completing GDM screening – particularly in hashtag#midwifery care settings
📣 Our findings strongly support recommending GDM screening for those with pre-pregnancy GDM risk factors
📣 Care providers should also be aware to screen for decreased fetal movement or low fetal growth among those who choose non-screening

Thanks to my wonderful co-author team- UBC Midwifery student Kelly Pickerill, UBC Midwifery Associate Professor Luba Butska, RM and Clinical Professor Michelle Turner, RM, UBC Professor Patricia Janssen, Associate Professor Jennifer Hutcheon and Assistant Professor Laura Schummers.