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Diagnosis of gestational diabetes

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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NICE (1) suggest testing criteria for gestational diabetes as:

  • use the 2-hour 75 g oral glucose tolerance test (OGTT) to test for gestational diabetes in women with risk factors (see below)

  • offer women who have had gestational diabetes in a previous pregnancy:
    • early self-monitoring of blood glucose or
    • a 75 g 2-hour OGTT as soon as possible after booking (whether in the first or second trimester), and a further 75 g 2-hour OGTT at 24-28 weeks if the results of the first OGTT are normal

  • offer women with any of the other risk factors for gestational diabetes a 75 g 2-hour OGTT at 24-28 weeks (see below)

  • glycosuria detected by routine antenatal testing
    • be aware that glycosuria of 2+ or above on 1 occasion or of 1+ or above on 2 or more occasions detected by reagent strip testing during routine antenatal care may indicate undiagnosed gestational diabetes. If this is observed, consider further testing to exclude gestational diabetes
  • risk factors for gestational diabetes:
    • BMI above 30 kg/m2
    • previous macrosomic baby weighing 4.5 kg or above
    • previous gestational diabetes
    • family history of diabetes (first-degree relative with diabetes)
    • minority ethnic family origin with a high prevalence of diabetes

  • diagnosis of gestational diabetes
    • diagnose gestational diabetes if the woman has either:

      • a fasting plasma glucose level of 5.6mmol/litre or above or

      • a 2-hour plasma glucose level of 7.8mmol/litre or above

Reference:


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