Optimizing the diagnosis of gestational diabetes mellitus: Clinical pathways and obstetric complications

Journal of Biomedical and Clinical Research 19: 59-67, doi: 10.3897/jbcr.e183593

Zlatko Kirovakov^‡, Elitsa H. Gyokova^§|, Nadezdha Hinkova^§¶, Nikolay Kostadinov^#, Antonia Andreeva^¤

‡ Faculty of Public Health, Burgas State University “D-r Asen Zlatarov”, Burgas, Bulgaria§ University Hospital “Saint Marina”, Pleven, Bulgaria| Faculty of Medicine, Medical University – Pleven, Pleven, Bulgaria¶ Faculty of Health Care, Medical University – Pleven, Pleven, Bulgaria# Faculty of Medicine, Burgas State University “D-r Asen Zlatarov”, Burgas, Bulgaria¤ Medical University – Pleven, Pleven, Bulgaria

Corresponding author: Zlatko Kirovakov ( kirovakov@yahoo.com )

Corresponding author: Elitsa H. Gyokova ( egyokova@yahoo.com )

Academic editor: Galya Stavreva

This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation: Kirovakov Z, Gyokova EH, Hinkova N, Kostadinov N, Andreeva A (2026) Optimizing the diagnosis of gestational diabetes mellitus: Clinical pathways and obstetric complications. Journal of Biomedical and Clinical Research 19: 59-67. https://doi.org/10.3897/jbcr.e183593

Abstract

The review critically synthesizes existing evidence on optimizing gestational diabetes mellitus (GDM) diagnostic procedures, focusing on best practices for early detection of at-risk mothers to address related obstetric complications. The review adopts the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic literature reviews and dissemination of study findings. The methodological framework follows three stages: planning, conducting the review, and reporting outcomes. The International Association of Diabetes and Pregnancy Study Group (IADPSG) screening criteria were more inclusive than those of other protocols, but no significant differences in maternal outcomes were reported between the protocols. One-step (75-g OGTT) performed relatively accurately compared with two-step screening (50-g GCT plus 75-g OGTT), even though no significant differences were reported, and the two-step screening was the more preferred diagnostic approach among participants. We found no statistically significant difference between early and routine Oral Glucose Tolerance Tests (OGTTs) in pregnancy outcomes. The review findings highlight the significant role of optimized diagnostic approaches in early detection of GDM to minimize the effects on pregnancy and related obstetric outcomes, as well as to reduce the incidence of diabetes mellitus later in life.

Keywords

glucose challenge test, glucose tolerance test, hyperglycemia, insulin sensitivity, neonatal hypoglycemia