At what gestational age should antenatal testing for GDM begin if medication or insulin is required?

Antenatal testing for gestational diabetes mellitus (GDM) that requires medication or insulin typically begins at 32 weeks of gestation. This timing is based on the understanding that the risks associated with uncontrolled blood glucose levels increase significantly as pregnancy progresses, especially after the third trimester.

At around 32 weeks, the fetus undergoes rapid growth and development, which increases its demand for glucose. Consequently, monitoring becomes crucial to ensure that maternal blood sugar levels are managed effectively, thus reducing the risk of complications such as macrosomia, preterm birth, or stillbirth. This approach ensures that both the mother and fetus are assessed appropriately, allowing for timely interventions that can optimize outcomes.

The other response options suggest starting antenatal testing either earlier or later than 32 weeks, which could inadequately address the risks associated with managing GDM and may lead to complications for both mother and child. The recommendation for beginning testing at 32 weeks aligns with guidelines that prioritize the health of both the mother and the fetus in the latter stages of pregnancy.