Gestational diabetes secondary prevention: Difference between revisions

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==Overview==
==Overview==
After delivery, mothers who diagnosed with GDM, should have close follow up to prevent overt diabetes in future. Testing with 75 g OGTT 6 to 12 weeks after delivery and then every 1-3 years is recommended for early diagnosis.
Following delivery, mothers diagnosed with GDM should have close follow ups to prevent overt diabetes in future. Testing with 75 g OGTT 6 to 12 weeks after delivery, and then every 1-3 years is recommended for early diagnosis of diabetes.
==Secondary Prevention==
==Secondary Prevention==
*The OGTT is recommended over A1C at the 6 to 12 week postpartum visit because A1C may be persistently impacted (lowered) by the increased red blood cell turnover related to pregnancy or blood loss at delivery.
*The OGTT is recommended over A1C at the 6 to 12 week postpartum visit because A1C may be persistently impacted (lowered) by the increased red blood cell turnover related to pregnancy or blood loss at delivery.
*Because GDM is associated with increased maternal risk for diabetes, women should also be tested every 1–3 years thereafter if 6 to 12 week 75-g OGTT is normal, with frequency of screening depending on other risk factors including family history, prepregnancy BMI and need for insulin or oral glucose lowering medication during pregnancy.
*GDM is associated with increased maternal risk for diabetes. Following delivery, women should be tested every 1–3 years ( if a 6 to 12 week 75-g OGTT is normal), with the frequency of screening depending on other risk factors such as family history of DM, prepregnancy BMI, and need for insulin or oral glucose lowering medications during pregnancy.
*Ongoing screening may be performed with any recommended glycemic test (e.g., hemoglobin A1C, fasting plasma glucose, or 75-g OGTT using nonpregnant thresholds).<ref name="pmid12351492">{{cite journal |vauthors=Kim C, Newton KM, Knopp RH |title=Gestational diabetes and the incidence of type 2 diabetes: a systematic review |journal=Diabetes Care |volume=25 |issue=10 |pages=1862–8 |year=2002 |pmid=12351492 |doi= |url=}}</ref>
*Continuous screening may also be performed with any recommended glycemic test (e.g., hemoglobin A1C, fasting plasma glucose, or 75-g OGTT using nonpregnant thresholds).<ref name="pmid12351492">{{cite journal |vauthors=Kim C, Newton KM, Knopp RH |title=Gestational diabetes and the incidence of type 2 diabetes: a systematic review |journal=Diabetes Care |volume=25 |issue=10 |pages=1862–8 |year=2002 |pmid=12351492 |doi= |url=}}</ref>
==References==
==References==


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[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Primary care]]
[[Category:Needs content]]
[[Category:Needs overview]]

Latest revision as of 17:36, 10 April 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Following delivery, mothers diagnosed with GDM should have close follow ups to prevent overt diabetes in future. Testing with 75 g OGTT 6 to 12 weeks after delivery, and then every 1-3 years is recommended for early diagnosis of diabetes.

Secondary Prevention

  • The OGTT is recommended over A1C at the 6 to 12 week postpartum visit because A1C may be persistently impacted (lowered) by the increased red blood cell turnover related to pregnancy or blood loss at delivery.
  • GDM is associated with increased maternal risk for diabetes. Following delivery, women should be tested every 1–3 years ( if a 6 to 12 week 75-g OGTT is normal), with the frequency of screening depending on other risk factors such as family history of DM, prepregnancy BMI, and need for insulin or oral glucose lowering medications during pregnancy.
  • Continuous screening may also be performed with any recommended glycemic test (e.g., hemoglobin A1C, fasting plasma glucose, or 75-g OGTT using nonpregnant thresholds).[1]

References

  1. Kim C, Newton KM, Knopp RH (2002). "Gestational diabetes and the incidence of type 2 diabetes: a systematic review". Diabetes Care. 25 (10): 1862–8. PMID 12351492.

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