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 28 May 2018

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This Appropriate Care Guide (ACG) features new recommendations for screening and diagnosing gestational diabetes mellitus. It highlights the shift from risk-based to universal screening for all women at 24 to 28 weeks of gestation, and WHO 1999 to IADPSG 2010 glucose thresholds for GDM. It also highlights the importance of long-term care for women with GDM history.

Download the PDF below to access the full ACG.

Key Messages
1.	During their first trimester, screen high-risk women for pre-existing diabetes using non-pregnancy glucose thresholds. If results are normal, re-evaluate women for GDM at 24 to 28 weeks of gestation.
2.	At 24 to 28 weeks of gestation, screen all pregnant women for GDM using 3-point 75 g OGTT unless they have pre-existing diabetes.
3.	At 6 to 12 weeks after delivery, reassess glycaemic status for women diagnosed with GDM using 2-point 75 g OGTT.
4.	Screen all women with GDM history for diabetes at least once every three years from then on.

GDM - An update on screening, diagnosis and follow-up (May 2018)