Evaluation of Gestational Diabetes

by Michael_Koger

The evaluation of gestational diabetes entails blood sugar assessment, long-term followup, and lifestyle change.

The clinical care of women who have gestational diabetes varies across the globe, and the guidelines emerge from several organizations. In the United States, the American Congress of Obstetricians and Gynecologists has published a great deal on the subject. The American Diabetes Association is another excellent source [1].

Outside the United States is the International Diabetes Federation in several countries. In the United Kingdom, the National Institute for Health and Care Excellence has much information. Moreover, the Canadian Diabetes Association offers a variety of resources [1].

Frequent Blood Sugar Screening

In any event, the care of these clients necessitates frequent evaluation in order to monitor the occurrence of situations which may require prompt action.  For example, most women need screening for gestational diabetes mellitus between the 24th and 28th weeks of pregnancy.  However, those who are at risk for that medical condition must have screening prior to the 24th week [1].

Those whose screening before 24 weeks gestation returns negative require another one when they reach the 24th week.  Nevertheless, some physicians believe that women whose risk for gestational diabetes is low need not undergo that many blood tests to assess for this condition [1].

There is also a need for close followup after discharge.  Specifically, screening for type 2 diabetes is necessary because that may be what the patient really has.  They need blood tests between six weeks and six months after delivery whenever the clinical appearance has been gestational diabetes.

Before and After Pregnancy

There is also the possibility of persistent diabetes or prediabetes in women who acquire the diagnosis of gestational diabetes.  Their screening must take place between six and 12 weeks after delivery, and further tests every one to three years is advisable.  Of course, these guidelines may require adjustment, and this will depend on the individual client’s situation [2].

For any patient with diabetes, lifestyle change with diet and exercise are quite useful as these measures enable the blood sugar to remain in good control.  In fact, all women of childbearing age, regardless of whether they have this disease or not, require counseling about these issues [1, 2]. 

Conclusion

The management of women who have gestational diabetes involves careful assessment, and after delivery there must be continuous care.

References

  1. Kelley, K., Carroll, D., and Meyer, A.  (2015).  A review of current treatment strategies for gestational diabetes mellitus.  Drugs in Context, 4, 212282.
  2. American Diabetes Association.  (2015).  Management of diabetes in pregnancy.  Section 12.  In Standards of Medical Care in Diabetes.  Diabetes Care, 38 (Suppl 1):  S77-S79.
  3. The photo shows a library at the U.S. Centers for Disease Control and Prevention and is reprinted with permission from that organization.

Disclaimer

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 08/30/2015, Michael_Koger
 
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