Gestational Diabetes

Gestational Diabetes: What is the diagnostic criteria?

According to NICE guidelines, gestational diabetes mellitus is diagnosed if the woman has either:

• a fasting plasma glucose level of >5.6 mmol/L; or

• a 2-hour post-oral glucose tolerance test plasma glucose level of >7.8 mmol/L

Gestational Diabetes: What are the risk factors?

1. BMI >30

2. Previous macrosomic baby (>4.5kg)

3. History of stillbirth

4. Previous gestational diabetes

5. First Degree Relative with Diabetes

6. Family origin with a high prevalence of diabetes (South Asia,Black Caribbean and Middle Eastern)

Gestational Diabetes: What is the management?

1. Diet and exercise

2. If not under 7 within 2 weeks, give metformin

3. If still uncontrolled, start insulin therapy

Gestational Diabetes: What are the complications of uncontrolled gestational diabetes?

• Macrosomic baby (>4.5kg)

• Neonatal seizures due to hypoglycaemia

Gestational Diabetes: When is an OGTT offered?

24-28 weeks gestation period