AIM: To evaluate the utility of the hemoglobin A1C(Hb A1C) at the first prenatal visit as a triaging tool in patients at high risk for gestational diabetes(GDM).METHODS: The Hb A1 C was obtained at the first prenatal visit prior to 20 wk. Women with a Hb A1 C ≥6.5%(group one) were instructed on diet and daily self-monitoring of blood glucose. Women with a Hb A1 C between 5.7%-6.4%(group two) were offered testing or daily self-monitoring of blood glucose. Women with a Hb A1 C < 5.7%(group three) were tested at 24-28 wk. Patients were tested for GDM using the two step testing and Carpenter and Coustan values as cutoffs. Medication was started if patients failed to meet glycemic goals of fasting ≤ 95 mg/d L(5.3 mmol/L) and 2 h postprandial ≤ 120 mg/d L(6.7 mmol/L).RESULTS: In group one(n = 16), 15/16(95%) required medication to achieve euglycemia. The mean gestational age at which medication was required was early at 14 ± 6 wk. Postpartum, 14/16 patients(87%) remained diabetic. Group two contained 82 patients. Sixty-sixpatients(80%) were given a diagnosis of GDMand 52 patients(64%) required medication. The mean gestational age at which medication was started in group two was 20 ± 7.8 wk. There were 205 patients in group three, 18 patients(8.7%) were diagnosed with GDM and 13 patients(6%) required medication. In comparison to group three, patients in group one were 220 times more likely to require medication(95%CI: 26.9- > 999, P < 0.0001). Patients in group two were 26 times more likely to require medication(95%CI: 12.5-54.3, P < 0.0001).CONCLUSION: A Hb A1 C obtained at the first prenatal visit can be used to triage patients based on the level of glucose intolerance found. AIM: To evaluate the utility of the hemoglobin A1C (Hb A1C) at the first prenatal visit as a triaging tool in patients at high risk for gestational diabetes (GDM). METHODS: The Hb A1 C was obtained at the first prenatal visit prior to Women with a Hb A1 C between 5.7% -6.4% (group two) were instructed on diet and daily self-monitoring of blood glucose. Self-monitoring of blood glucose. Women with a Hb A1 C <5.7% (group three) were tested at 24-28 wk. Patients were tested for GDM using the two step testing and Carpenter and Coustan values ​​as cutoffs. Medication was started if Patients failed to meet glycemic goals of fasting ≤ 95 mg / d L (5.3 mmol / L) and 2 h postprandial ≤ 120 mg / d L (6.7 mmol / L) .RESULTS: In group one (n = 16) The mean gestational age at which the medication was required was early at 14 ± 6 weeks. Postpartum, 14/16 patients (87%) TLC of the diabetic Sixty-six patients (80%) were given a diagnosis of GDM and 52 patients (64%) required. The mean gestational age at which the medication was started in group two was 20 ± 7.8 wk. in group three, 18 patients (8.7%) were diagnosed with GDM and 13 patients (6%) required medication. In three groups, patients in group one were 220 times more likely to require medication (95% CI: 26.9-> 999, P <0.0001). Patients in group two were 26 times more likely to require treatment (95% CI: 12.5-54.3, P <0.0001) .CONCLUSION: A Hb A1 C obtained at the first prenatal visit can be used to triage patients based on the level of glucose intolerance found.