Advertisement
Feature Article

Gestational diabetes: towards new diagnostic criteria

Arianne N Sweeting, Victoria L Rudland, Glynis P Ross

Figures

Abstract

The Australasian Diabetes in Pregnancy Society (ADIPS) has been revising its consensus guidelines for the testing and diagnosis of gestational diabetes but these have not yet been translated into a unified approach to the condition in Australia. Controversy over the diagnosis of gestational diabetes persists internationally. Key practice points for general practitioners arising from the revised guidelines are reviewed.

Key Points

  • The Australasian Diabetes in Pregnancy Society has been revising its guidelines for the testing and diagnosis of gestational diabetes. Ongoing controversy over diagnostic criteria is delaying a unified approach to the condition within Australia.
  • Gestational diabetes is associated with adverse maternal and neonatal outcomes at even lower blood glucose levels than previously recognised.
  • Universal testing with a one-step 75 g two-hour oral glucose tolerance test at 24 to 28 weeks of gestation is recommended.
  • Treatment ideally involves a multidisciplinary approach focusing on patient education, dietary modification and lifestyle intervention. Medication should be initiated when treatment targets are not achieved by diet alone.
  • General practitioners play a crucial role in detecting undiagnosed pre-existing diabetes in high-risk women before or in early pregnancy, and ensuring timely postpartum follow up and risk factor modification to reduce the risk of future diabetes.

Figures