Feature Article

Gestational diabetes: practice points for GPs

Feature Article

Gestational diabetes: practice points for GPs

Pat Phillips, Bill S Jeffries

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Abstract

A 30-year old with a family history of diabetes, hypertension and cardiovascular disease has an abnormal result on a glucose challenge test in her first pregnancy. What are your next steps?

Key Points

  • All pregnant women should be checked for gestational diabetes at about 26 to 28 weeks.
  • High risk women should be checked before conception and at 12, 26 to 28 and 32 weeks’ gestation.
  • A shared-care multidisciplinary approach is the key to successful management.
  • Lifestyle modification and insulin therapy may be needed.
  • Target blood glucose values during the pregnancy are below 5.5 mmol/L before meals and below 7.0 mmol/L two hours after meals.
  • Extra obstetric monitoring may be required.
  • Advise on the risk of diabetes to the child, with future pregnancies and in the long term.
  • Consider assessing other cardiovascular risk factors.