SCREENING AND DIAGNOSIS

POSTPARTUM FOLLOW-UP

Self-Monitoring Blood Glucose Goals

MEDICAL NUTRITION THERAPY (MNT) AND PHYSICAL ACTIVITY**

BLOOD GLUCOSE MONITORING

MEDICATION MANAGEMENT

PRENATAL SURVEILLANCE AND DELIVERY MANAGEMENT

can be used with selected patients during pregnancy.

Monthly ultrasounds in the 3rd trimester to evaluate fetal growth; if LGA (>90% fetal weight/ gestational age) identified, antepartum fetal testing with NST/BPP should be considered.

GUIDELINES FOR GESTATIONAL DIABETES

may be considered as an alternative to insulin.

92

153The diagnosis of GDM is made

when any of the following plasmaglucose values are exceeded.

• Perform a 75-g OGTT, with plasma glucose measurement fasting and at 1 & 2 hours, at 24-28 weeks of gestation in women not previously diagnosed with overt diabetes.

Ges

tatio

nal D

iabe

tes

Post

part

um F

ollo

w-u

p

Wom

en w

ith G

DM

hav

e an

app

roxi

mat

e 50

% r

isk

for

deve

lopi

ng

type

2 d

iabe

tes

with

in th

e ne

xt 5

–10

year

s an

d 80

% r

isk

if th

ey

have

impa

ired

fast

ing

gluc

ose

or im

pair

ed g

luco

se to

lera

nce

post

part

um.

Ther

efor

e it

is c

ruci

al th

ey r

etur

n to

thei

r pr

ovid

er to

rec

eive

the

appr

opri

ate

po

stpa

rtum

cou

nsel

ing,

test

ing,

and

follo

w-u

p af

ter

a G

DM

pre

gnan

cy.

Nor

mog

lyce

mia

N

orm

ogly

cem

ia

Pre

-dia

bete

sP

re-d

iab

ete

s(I

FG

or

IGT

)(I

FG

or

IGT

)Ty

pe 2

Dia

bete

s M

ellit

us

Type

2 D

iabe

tes

Mel

litus

Po

stp

artu

m e

du

cati

on

for

all w

om

en w

ith

pri

or

GD

M:

Po

stp

artu

m e

du

cati

on

for

all w

om

en w

ith

pri

or

GD

M:

Rec

lass

ific

atio

n C

rite

ria

for

Po

stp

artu

m M

ater

nal

Gly

cem

ic S

tatu

s R

ecla

ssif

icat

ion

Cri

teri

a fo

r P

ost

par

tum

Mat

ern

al G

lyce

mic

Sta

tus

Ges

tatio

nal D

iabe

tes

Scre

enin

g an

d D

iagn

osis

Un

iver

sal S

cree

nin

g

Un

iver

sal S

cree

nin

g

NO

N

O

YE

S

YE

S

No

abno

rmal

val

ues

No

abno

rmal

val

ues

1 ab

norm

al v

alue

1 ab

norm

al v

alue

2 or

mor

e ab

norm

al v

alue

s2

or m

ore

abno

rmal

val

ues

1 Se

e Sc

reen

ing

sect

ion

in G

esta

tiona

l Dia

bete

s G

uide

lines

2

Am

eric

an D

iabe

tes

Ass

ocia

tion,

Car

pent

er a

nd C

oust

an

Wom

an h

as G

DM

W

oman

has

GD

M

2

Un

iver

sal R

isk

Ass

essm

ent

Un

iver

sal R

isk

Ass

essm

ent

NO

N

O

STO

P

STO

P

6-12

Wee

ks P

ost

par

tum

6-

12 W

eeks

Po

stp

artu

m