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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 1

Category: Diabetes

Poster Session 1

(310) Impact of the American College of Obstetricians and Gynecologists (ACOG) Pregestational Diabetes 2024 Screening Update

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Nicole Loza, BA

    Second-Year Medical Student
    Duke University School of Medicine
    Duke University/Durham, North Carolina, United States

    • Coauthor(s)

  • AP

    Alexis D. Pean, BS, MS

    Student
    Duke University School of Medicine
    Duke University/Durham, North Carolina, United States

  • TL

    Tina Liu, BA

    Second-Year Medical Student
    Duke University School of Medicine
    Duke University/Durham, North Carolina, United States

  • NK

    Navya Kancharla

    Undergraduate Student
    Duke University School of Medicine
    Duke University/Durham, North Carolina, United States

  • Rachel L. Wood, MD (she/her/hers)

    Assistant Professor of Obstetrics and Gynecology
    Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University
    Durham, North Carolina, United States

  • MM

    Madeline Morello, BS, MS

    Manager of Quality and Safety
    Department of Obstetrics and Gynecology, Duke University
    Durham, North Carolina, United States

  • SD

    Sarah K. Dotters-Katz, MD

    Associate Professor of Obstetrics and Gynecology
    Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University
    Duke University/Durham, North Carolina, United States

Objective:
In July 2024, ACOG updated gestational diabetes screening guidelines, pivoting from early glucose tolerance test(GTT) to early testing for undiagnosed pre-existing pre-gestational diabetes(DM) in high-risk patients- defined as BMI >25 (>23 in Asian Americans) & at least 1 other risk factor. We implemented a protocol following these guidelines Sept 2024. We evaluated implementation accuracy of 2024 ACOG diabetes screening guidelines.

Study Design:

IRB approved retrospective cohort study of patients presenting for initial OB visit in the 1st trimester within the first 3 months of guideline implementation (10/1-12/31/2024) in our large academic health system. Outcome measure was percent of patients correctly screened for diabetes testing(with A1c). Process measures included: % receiving A1c who should not have, % not receiving A1c who should have, & common screening errors.


Results:

962 patients presented for an initial prenatal visit in the 1st trimester in the study period. 766(79.6%) were correctly screened for A1c testing, including 31(3.2%) with known DM. 179(18.6%) patients were incorrectly screened & 17(1.8%) were correctly screened but did not have correct DM test performed. Of 179 incorrectly screened, 112(62.6% of incorrectly screened) had unindicated A1c drawn, including 54(30.2%) who did not meet BMI threshold & 58(32.4%) who met the BMI threshold but had no additional risk factor. Of note, white patients were most likely to be incorrectly tested on basis of BMI alone(n=32). None of the incorrectly tested patients were found to have pre-existing DM. Of the 84 that should have had A1c drawn,  67(79.7% of those missing indicated A1c) were incorrectly screened, 5(6.0%) screened correctly but A1c not ordered, 8(9.5%) had A1c ordered but not drawn, & 4(4.8%) had GTT ordered(Figure 1).


Conclusion:

With implementation of the new ACOG screening guidelines, correct application of screening occurred in 79.6% individuals. The majority of missed screening resulted in over testing for DM. Continued education is necessary to increase screening accuracy.