Gestational Diabetes

by Veronica Gillispie, MD, FACOG

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    Now let's talk about gestational diabetes. All pregnant women should be screened for gestational diabetes between 24 to 28 weeks gestational age. Now there are some women that are at high-risk and they should be screened in the first trimester and again at 24 to 28 weeks if negative in the 1st trimester. Let's talk about some of those high-risk factors. So previous history of gestational diabetes. If they are obese meaning BMI greater than 30 kilograms per meter square. If they have advance maternal age meaning older than 35 years old. Certain ethnic groups including African-American, Hispanic women. And then if they have a history of an infant with macrosomia. Again these women should be screened in the 1st trimester. So what does the screening entail? Well, we tell patients to eat their normal diet but not anything too sugary. They go to the lab, they drink a 50 gram oral glucola test. And then after an hour their blood sugar is drawn. If the value is greater than 140 milligrams per decalitre, that's considered a positive screen. But again this is a screening test. So now we need to do the confirmation test. So the confirmation test is actually a three hour test. So for patients that are being diagnosed with gestational diabetes, they have a test that involves a fasting blood sugar. They drink a 100 gram glucose drink. And their blood sugar is drawn at 1 hour, 2 hours and 3 hours. So what's considered abnormal for this now screening to diagnosing gestational diabetes. If a fasting blood sugar is greater than 95 milligrams per decalitre, 1 hour greater than 180, 2 hours greater than 155 or 3 hours greater than 140. Those are the normal values. If two or more of these are abnormal then...

    About the Lecture

    The lecture Gestational Diabetes by Veronica Gillispie, MD, FACOG is from the course Antenatal Care. It contains the following chapters:

    • Gestational Diabetes
    • Diagnosing Gestational Diabetes

    Included Quiz Questions

    1. All pregnant women
    2. Pregnant women with a family history of diabetes
    3. Pregnant women with a history of gestational diabetes
    4. Pregnant women who are obese
    5. Pregnant women who have glucosuria
    1. High risk pregnant women who already have gestational diabetes diagnosed from their first trimester screening
    2. Women who have a history of at least two normal pregnancies and no diagnosis of gestational diabetes in the past
    3. Women who have a BMI less than 20
    4. Women who are caucasion
    5. Women who are less than 35 years old
    1. Perform a 3 hour confirmation test with 100g oral glucose drink
    2. Start dietary management of gestation diabetes
    3. Proceed with routine prenatal care
    4. Start oral hypoglycemic treatment for gestational diabetes
    5. Start insulin management of gestational diabetes
    1. Start dietary management of for gestational diabetes and follow up in 2 weeks
    2. Start oral hypoglycemic management for gestational diabetes and follow up in 2 weeks
    3. Start insulin management for gestational diabetes and follow up in 1 week
    4. Results are borderline so perform 3 hour confirmation test again in 1 week
    5. Results are within normal rage, so proceed with routine follow up

    Author of lecture Gestational Diabetes

     Veronica Gillispie, MD, FACOG

    Veronica Gillispie, MD, FACOG

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