Gestational diabetes resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Synonyms and keywords:

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Diagnosis

Shown below is an algorithm summarizing the diagnosis of gestational diabetes according the American College of Obstetricians and Gynecologists guidelines[1][2].

 
 
 
All pregnant women should be screened for GDM at 24 weeks or more of gestation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Two-step screening approach is recommended
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
50g of oral glucose load is administered to the patient followed by measurement of venous blood glucose level after 1 hour
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Blood glucose level equal or higher than 190mg/dl or 10.6mmol/l
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
No
 
 
 
 
 
 
 
 
 
 
 
 
100g of oral glucose load is administered to the patient followed by measured of venous blood glucose level after 3 hours
 
Second screening test not required
 
 
 
 
 
 
 
 
 
 
 
Blood glucose level equal or more than 145mg/dl or 8mmol/l
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Gestational diabetes mellitus diagnosed when there is an abnormal blood glucose level 2 or more times
 
 
 
 

Treatment

Shown below is an algorithm summarizing the treatment of gestational diabetes according to the American Diabetes Association guidelines.

 
 
 
 
 
 
 
Patients with confirmed gestational diabetes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Lifestyle and dietary modification along with regular monitoring of blood glucose levels.
  • Food with low or medium glycemic index along with high intake of fiber, fresh fruits, and vegetables.
  • An active lifestyle with increased physical activity
  • The patient is advised to monitor blood glucose levels 4 to 7 times each day.
  • Blood glucose level maintained in the normal range
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

References

  1. "ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus". Obstet Gynecol. 131 (2): e49–e64. 2018. doi:10.1097/AOG.0000000000002501. PMID 29370047.
  2. American Diabetes Association (2017). "13. Management of Diabetes in Pregnancy". Diabetes Care. 40 (Suppl 1): S114–S119. doi:10.2337/dc17-S016. PMID 27979900.


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