ACE Clinical Guidances (ACGs)

[also known as Appropriate Care Guides]

ACGs provide concise, evidence-based recommendations to inform specific areas of clinical practice and serve as a common starting point nationally for clinical decision-making. ACGs are underpinned by a wide array of considerations contextualised to Singapore, based on best available evidence at the time of development. Each ACG is developed in collaboration with a multidisciplinary group of local experts representing relevant specialties and practice settings. ACGs are not exhaustive of the subject matter and do not replace clinical judgement.

Published on 28 May 2018
Last Updated on 22 Aug 2022

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This Appropriate Care Guide (ACG) features recommendations for identification of diabetes during pregnancy. It focuses on screening for pre-existing diabetes in women at increased risk, and on universal screening for gestational diabetes mellitus in all women at 24 to 28 weeks of gestation using IADPSG 2010 glucose thresholds. The ACG also highlights the importance of long-term follow-up and postpartum management for all women diagnosed with diabetes during pregnancy.

First published in 2018, this ACG has been updated in 2022 to incorporate the latest evidence where relevant.

Download the PDF below to access the ACG.

Key Messages
1.	During their first trimester, screen for pre-existing diabetes in women at increased risk of it using non-pregnancy glucose thresholds. If results are normal, re-evaluate women for gestational diabetes mellitus (GDM) at 24 to 28 weeks of gestation.
2.	At 24 to 28 weeks of gestation, screen all women for GDM using 3-point 75 g oral glucose tolerance test (OGTT) unless they have already been diagnosed with diabetes or pre-diabetes.
3.	At 6 to 12 weeks after delivery, reassess glycaemic status in women with diabetes diagnosed during pregnancy using 2-point 75 g OGTT. If results are normal, screen women with a history of diabetes diagnosed during pregnancy for diabetes every 1 to 3 years (ideally annually) from then on.

GDM – an update on screening, diagnosis, and follow-up (Updated on 22 August 2022) GDM – an update on screening, diagnosis, and follow-up references (August 2022)

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ACE Clinical Guidances (ACGs)