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WHO- GDM can be diagnosed any time during pregnancy. NICE- assess for risk factors and test if needed. One step 75 g oral glucose tolerance test at 24 -28 weeks of gestation
Risk factors -BMI of > 30 Previous macrosomic baby weighing 4.5 kg or more Previous gestational diabetes Family h/o diabetes ( 1st degree relative with diabetes ) Family origin with a high prevalence of diabetesâ—‹ S Asian particularly if family origin from India , Pakistan or Bangladeshâ—‹ Black Caribbeanâ—‹ Middle Eastern (particularly if family origin from Saudi Arabia , UAE , Iraq , Jordan , Syria , Oman , Quatar , Kuwait , Lebanon or Egypt )
Commonest medical complication of pregnancy Associated with excess fetal growth & adiposity with subsequent risk of birth trauma , hypertensive disorder of pregnancy Increased 35 % to 60 % of developing diabetes mellitus over 10-20 yrs period after pregnancy Marker of premature CV risk in women.
References
Diabetes in pregnancy: management from preconception to the postnatal period NICE NG 3 2015 https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#gestational-diabetes
BMJ Best Practice Summary Gestational Diabetes Mellitus https://bestpractice.bmj.com/topics/en-gb/665
Gestational diabetes https://www.frontiersin.org/articles/10.3389/fcdhc.2020.546256/full
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