Selection for presymptomatic testing for Huntington's disease: who decides? A reply from the Victorian Clinical Genetics Service, Murdoch Institute, Melbourne, Australia.

OBJECTIVE To assess random venous blood glucose (RBG) measurement at antenatal booking to detect “overt diabetes in pregnancy” (ODIP). RESEARCH DESIGN AND METHODS A retrospective analysis of regional hospital obstetric data from 2004–2008 was performed. Universal RBG screening was included at booking. Oral glucose tolerance test (OGTT) was administered if RBG >7.0 mmol/L or other indication, e.g., if a 50-g glucose challenge test was >7.7 mmol/L at 26–28 weeks. ODIP was based upon World Health Organization plasma glucose criteria for diabetes. RESULTS RBG data were collected from 17,852/26,369 (67.7%) pregnancies around the initial antenatal visit; 3,007 women had an OGTT. The receiver operator curve area under the curve for RBG to detect ODIP was 0.86 (0.80–0.92) (assuming women without an OGTT did not have ODIP). CONCLUSIONS RBG at booking may provide a sufficiently sensitive screening tool for the detection of ODIP. We recommend further studies and comparison with fasting glucose and HbA1c.