By rray, 28 November, 2014 All pregnant women should be screened for GDM, whether by hx,<sup>4</sup> clinical risk factor assessment, or labs. [B] Screen @ 24-28 wks, including pts who tested (-) on early screen. 2-step testing is common:
By rray, 28 November, 2014 If (+): Monitor BG<sup>6</sup> while on nutrition tx [C], starting 4x/day (fasting and 1 or 2 h post-meals); then modify freq. once controlled. Antepartum fetal surveillance may be beneficial if GDM glycemic control is poor.<sup>7</sup>
By rray, 28 November, 2014 Step 2: If 50-g 1-h meets/exceeds threshold, then order 100-g 3-h diagnostic OGTT. Select (+) test threshold:<sup>5</sup> 140 or 145 mg/dL. [C]
By rray, 28 November, 2014 Step 1: 50-g PO glucose followed by 1-h venous glucose level. Select (+) test threshold:<sup>5</sup> 135 or 140 mg/dL. [C]
By rray, 28 November, 2014 If early screen (+): Monitor BG2 while on nutrition tx [C], starting 4x/day (fasting and 1 or 2 h post-meals); then modify freq. once controlled. Antepartum fetal surveillance may be beneficial if GDM glycemic control is poor.3
By rray, 28 November, 2014 Step 2: If 50-g 1-h meets/exceeds threshold, then order 100-g 3-h diagnostic OGTT. Select (+) test threshold:1 140 or 145 mg/dL. [C]
By rray, 28 November, 2014 Step 1: 50-g PO glucose followed by 1-h venous glucose level. Select (+) test threshold:1 135 or 140 mg/dL. [C]