IRCT138707081281N1 IRCT 2017-02-15 National institute for medical research development Comparison of various protocoles for management of gestational diabetes To compare the maternal, fetal and cost-effectiveness outcomes in 5 different screening strategies for gestational diabetes among pregnant women with ≤ 14 weeks of gestation 2017-02-19 anticipated 39500 Complete https://irct.ir/trial/518 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Health service research, Other design features: At first, five provinces in the different geographical regions of north, south, east, west and center of the country including Yazd, Khorasan, south Kordestan, Golestan and Bushehr will be invited. The 5 selected cities from each province will be interred to the study. In each province, based on socioeconomic differences the cities will be divided in to two cluster: the center of province and other cities. The 5 protocol will be randomly allocated among cities in this two cluster. N/A Gestational Diabetes. Intervention 1: Protocol A: In this protocol, the screening test in first pregnancy trimester will be fasting blood sugar (FBS). In addition, all of women with mild gestational diabetes will receive standard treatment. If those women do not affected by GDM in the 1th screening test, they will invite for 2ed trimester of GDM screening at 24-28 weeks of gestations by one step approach with OGTT -75 g Glucose. It will be considered as GDM, if one abnormal test detect. Intervention 2: Protocol B: In this protocol, the screening test in first pregnancy trimester will be fasting blood sugar (FBS). In addition, all of women with mild gestational diabetes will not receive standard treatment. If those women do not affected by GDM in the 1th screening test, they will invite for 2ed trimester of GDM screening at 24-28 weeks of gestations by one step approach with OGTT -75 g Glucose. It will be considered as GDM, if two abnormal test detect. Intervention 3: Protocol C: In this protocol, the screening test in first pregnancy trimester will be fasting blood sugar (FBS). In addition, all of women with mild gestational diabetes will not receive standard treatment. If those women do not affected by GDM in the 1th screening test, they will invite for 2ed trimester of GDM screening at 24-28 weeks of gestations by one step approach with OGTT -75 g Glucose. It will be considered as GDM, if one abnormal test detect. Intervention 4: Protocol D: In this protocol, the screening test in first pregnancy trimester will be fasting blood sugar (FBS). In addition, all of women with mild gestational diabetes will receive standard treatment. If those women do not affected by GDM in the 1th screening test, they will invite for 2ed trimester of GDM screening at 24-28 weeks of gestations by two step approach with OGTT -100 g Glucose. Intervention 5: Protocol E: In this protocol, the screening test in first pregnancy trimester will be fasting blood sugar (FBS). In addition, all of women with mild gestational diabetes will not receive standard treatment. If those women do not affected by GDM in the 1th screening test, they will invite for 2ed trimester of GDM screening at 24-28 weeks of gestations by two step approach with OGTT -100 g Glucose.