Diagnosis for Gestational Diabetes

 

Diagnosis of Gestational Diabetes was discussed at The Fifth International Workshop Conference on Gestational Diabetes Mellitus (GDM) which was held in Chicago, IL, 11–13 November 2005 under the sponsorship of the American Diabetes Association. The meeting provided a forum for review of new information concerning Gestational Diabetes Mellitus in the areas of pathophysiology, epidemiology, perinatal outcome, long-range implications and for mother and her offspring, and managing diabetes strategies. The issues regarding strategies and criteria for the detection and diagnosis of Gestational Diabetes.

The diagnosis of Gestational Diabetes to women with glucose levels in the upper 5–10% of the population distribution. The hyperglycemia varies in severity from glucose concentrations that would be diagnosis of diabetes outside of pregnancy to concentrations that are asymptomatic and only slightly above normal, but associated with some increased risk of fetal morbidity. Here’s the gestational diabetes levels :

A. Low risk: Blood gllucose testing not routinely required if all of the following characteristics are present:
● Member of an ethnfic group withh a low prevalence of Gestational Diabetes Mellitus
● No known diabetes in first-degree relatives
● Age 25 years
● Weight normal before pregnancy
● Weight normal at birth
● No history of abnormal glucose metabolism
● No history of poor obstetric outcome

B.Average risk: Perform blood glucose testing at 24–28 weeks using either:
● Two-step procedure: 50 g glucose challenge test (GCT) followed by a diagnostic oral
glucose tolerance test in those meeting the threshold value in the GCT.
● One-step procedure: Diagnostic oral glucose tolerance test performed on all subjects.

C. High-risk: Perform blood glucose testing as soon as feasible, using the procedures described above if one or more of these are present:
● Severe obesity
● Strong family history of type 2 diabetes
● Previous history of: Gestational diabetes mellitus, impaired glucose metabolism, or glucosuria

If diagnosis of gestational diabetes was not clear, blood glucose testing should be repeated at 24 –28 weeks or at any time a patient has symptoms or signs that are suggestive of hyperglycemia.
Gestational diabetes complication such as Maternal hyperglycemia continues to be viewed as the primary determinant of increased fetal growth via delivery of glucose to the fetus, which leads to fetal hyperinsulinemia.

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