Screening for Diabetes in Women
Screening for diabetes in women is vital—early detection can prevent complications like heart disease, kidney issues, and vision loss.
Who Should Be Screened?
Type 2 diabetes screening is recommended for:
- Adults aged **35–70 (USA)** with overweight or obesity (BMI ≥ 25; ≥23 for Asian individuals) :contentReference[oaicite:2]{index=2}
- All adults aged **≥ 35 (ADA)** even without risk factors, repeating every 3 years :contentReference[oaicite:3]{index=3}
- High-risk individuals (family history, PCOS, hypertension, history of gestational diabetes) more frequently :contentReference[oaicite:4]{index=4}
Which Tests Are Used?
- Fasting plasma glucose: <6.9 mmol/L normal, 7.0+ = diabetes :contentReference[oaicite:5]{index=5}
- HbA₁c: < 5.7% normal; 5.7–6.4% prediabetes; ≥ 6.5% diabetes :contentReference[oaicite:6]{index=6}
- Oral glucose tolerance test (OGTT): 75 g, 2hr measurement; ≥ 11.1 mmol/L = diabetes :contentReference[oaicite:7]{index=7}
Diagnosis should be confirmed on a separate day if symptoms are unclear :contentReference[oaicite:8]{index=8}.
How Often Should Women Be Screened?
- If initial tests are normal → repeat every **3 years** :contentReference[oaicite:9]{index=9}
- Women with **prediabetes** or risk factors → **annual** screening :contentReference[oaicite:10]{index=10}
Screening During Pregnancy (Gestational Diabetes)
Gestational diabetes screening is universally advised for pregnant women between **24–28 weeks** :contentReference[oaicite:11]{index=11}.
High-risk women (BMI ≥ 25, PCOS, previous GDM) should be tested **earlier**, often at first prenatal visit, using fasting glucose or HbA₁c :contentReference[oaicite:12]{index=12}.
Common approach:
- 1-step: 75-g OGTT
- 2-step: 50-g glucose challenge followed by 100-g OGTT if needed :contentReference[oaicite:13]{index=13}
Recent Australasian guidelines raised thresholds to reduce overdiagnosis in low-risk women :contentReference[oaicite:14]{index=14}.
Why Timely Screening Matters for Women
- Women are often diagnosed later than men, increasing risks of complications like heart disease :contentReference[oaicite:15]{index=15}
- Gestational diabetes boosts future type 2 risk up to **eightfold** :contentReference[oaicite:16]{index=16}
- Screening with OGTT can catch early dysglycaemia missed by HbA₁c, especially in younger women :contentReference[oaicite:17]{index=17}
Recommended Screening Schedule
| Life Stage | When & How | Frequency |
|---|---|---|
| Adult women (≥ 35) with overweight | FPG, HbA₁c or OGTT | Every 3 years (annual if prediabetes) |
| High-risk women (any age) | Begin earlier; test annually | Annually |
| Pregnant women | 24–28 weeks OGTT (or glucose challenge) | Once per pregnancy (earlier if risk) |
FAQs
Can HbA₁c miss diabetes in women?
Yes—HbA₁c may underdiagnose younger women. OGTT is often more sensitive in early detection :contentReference[oaicite:18]{index=18}.
What if prediabetes is found?
Begin lifestyle changes and repeat screening **annually**. Prediabetes can progress, but interventions reduce risk substantially :contentReference[oaicite:19]{index=19}.
Are pregnant women always screened?
Yes—universal screening at 24–28 weeks. High-risk women are tested sooner :contentReference[oaicite:20]{index=20}.
Conclusion
Women should begin diabetes screening by the **age of 35** if overweight, earlier if high-risk, and repeat every few years or annually depending on risk. Pregnancy screening is essential for maternal and fetal health. A thoughtful, timely approach helps prevent serious long‑term complications.