Gestational Glucose Tolerance Screening and Diagnostic Test (Two-hour, ADA Recommendations)

CPT 82951
Synonyms
  • Glucose Tolerance Test, Gestational (Fasting, One-hour, and Two-hour)

Test Details

Use

Screening and diagnosis of gestational diabetes

Methodology

Enzymatic

Additional Information

American Diabetes Association Standards of Medical Care in Diabetes recommendations:2

• Screen for undiagnosed type 2 diabetes at the first prenatal visit in those with risk factors using the standard nongestational diagnostic criteria.

• In pregnant women not known to have diabetes, screen for gestational diabetes mellitus (GDM) at 24 to 28 weeks of gestation using the Gestational Glucose Tolerance Screening and Diagnostic Test (Two-hour, ADA Recommendations).

• Screen women with GDM for persistent diabetes 6 to 12 weeks postpartum using nonpregnant OGTT criteria, hemoglobin A1c (102525), fasting plasma glucose (001818), or a 75-gram, two-hour oral glucose tolerance test (101200), two specimen WHO glucose tolerance test).2 Women diagnosed with GDM should, in subsequent pregnancies, be re-evaluated.

• Women with a history of GDM should have lifelong screening for the development of diabetes or prediabetes at least every three years.

Note: The American Diabetes Association (ADA) released recommendations that vary from the American College of Obstetrics and Gynecology (ACOG) recommendations. The ADA recommends the current (101000) simplified “one-step” for screening and diagnosis of gestational diabetes mellitus using a 75-gram, two-hour glucose tolerance test. The ACOG recommendations3 use a 100-gram, three-hour glucose tolerance test (102004).

Specimen Requirements

Information on collection, storage, and volume

Specimen

Serum or plasma

Volume

1 mL serum or plasma each tube

Minimum Volume

0.5 mL serum or plasma each tube

Container

Gel-barrier tubes (3) or gray-top (sodium fluoride/potassium oxalate plasma) tubes (3)

Storage Instructions

Maintain specimen at room temperature.1

Causes for Rejection

Frozen gray-top tube (frozen plasma from gray-top is acceptable); stressed patient (surgery, infection, corticosteroids) should not have GTT; specimens not labeled with collection time intervals (i.e., fasting, one-hour, and two-hour)

Collection

Draw a fasting blood sample before administering glucose. Administer a 75-gram glucose and draw blood after one hour and two hours. The patient should remain seated throughout the test. Submit 1 mL serum or plasma for fasting, one-hour, and two-hour specimens. Separate serum or plasma from cells within 45 minutes of venipuncture. Gray-top tubes only, may be submitted without centrifugation. Label each tube with the patient's name and collection time interval (i.e,, fasting, one-hour, and two-hour).