Who is at risk? Recommendations for future
If you circled yes to any of the self assess- testing. PREGNANCY
ment questions you could be at a higher If you have had gestational diabetes in
risk of developing gestational diabetes. pregnancy you should have a repeat blood
test when your baby is 6wks old and then
Instructions for accurate have a blood test every 2 years. Information is
testing for 2hr glucose test empowerment for all.
Three days unrestricted, carbohydrate
Preventative Dietary Advice
rich diet and activity. Maintain a healthy weight.
No medication on the day of the test. Exercise
12-h fast. Consider maintaining healthy fitness.
Questions to ask.
Do I have a mild or serious form of gesta-
Farrar,D,Duley L,Lawlor, D.A. (2009) Alternative tests for
diagnosing gestational diabetes (protocol) The Cochrane Collabo-
ration Retrieved from the Cochrane library 19/11/09
Diabetes New Zealand
There is almost clinical consensus to treat http://www.diabetes.org.nz/about_diabetes/gestatio
severe forms of gestational diabetes. How-
Reinauer,H. Home, PD, Kanagasabapathy A.S.
ever, treating the milder forms of gesta- (2002) WHO Laboratory Diagnosis and Monitor-
tional diabetes is more controversial ing of Diabetes Mellitus
Diabetes Action Now
If I believe I am at low risk of developing
gestational diabetes do I need to be xt%20ENGLISH.pdf
Definition and diagnosis of diabetes mellitus and inter-
Screening during pregnancy can be con- mediate hyperglycaemia Report WHO/IDF con-
troversial when pregnancy and birth are sultation WHO 2006 http://www.who.int/
supposed to be kept as a normal life event diabetes/publications/Definition%20and%
which occurs to healthy women. 20diagnosis%20of%20diabetes_new.pdf
Khatib OMN,(2006) Guidelines for the preven-
tion and management of diabetes mellitus.
Alwan N, Tuffnell DJ,West J. (2009) Treatments
Future implications for your for gestational diabetes The Cochrane Collabo-
health Pairman, Pincombe, Thorogood, Tracy. (2006)
Pamela Harnden 04002987
Midwifery Preparation for Practice. Elsevier
Women who have developed diabetes Tieu J, Crowther CA, Middleton P. Dietary ad- If you are worried, concerned or
during pregnancy are at greater risk of vice in pregnancy for preventing gestational have any questions you should con-
diabetes mellitus. Cochrane Database of Sys- tact your lead Maternity Carer.
type 2 diabetes later in life . tematic Reviews 2008, Issue 2. Art. No.:
GESTATIONAL DIABETES (GDM)
Self Assessment Questionnaire
Screening for gestational
1. Do you have a family history of What is gestational diabetes? diabetes.
type 2 diabetes? (Parents/brothers/
Gestational diabetes occurs when a preg- 1.) High Risk– Fasting blood glucose test
sisters) Yes No
nant woman has high levels of glucose in in the 1st trimester
2. Have you had diabetes in a pre- her blood. High blood glucose is caused
2.) High Risk & average risk—A 2hr glu-
vious pregnancy? Yes No because the mother can’t produce enough
cose test at 24-28wks.
insulin (a pregnant woman’s insulin needs
3. Have you had a previous baby
are two to three times that of normal).There 3.) Low risk—1hr glucose test at 24-
with a birth defect?
are two reasons why the mother needs more 28wks
3.) Urine testing at each A/N visit
4. Are you very overweight?
Because pregnancy causes certain types of
hormones (that are made by the placenta) to Fasting blood test in 1st
5. Are you over the age of 30? be released. These hormones make it 12wks will detect 40% of
Yes No harder for insulin to do its job
6. Have you had a stillborn baby Because the growth demands of the foetus
or a spontaneous miscarriage? (developing baby) increases the mother's Fast from 12mn and then have a blood
Yes No need for insulin. In most cases women will test taken at the lab. Follow that up later
have no symptoms of having the condition. in pregnancy with :-
7. Have you previously had a
The condition temporarily occurs during
baby which weighed more than
pregnancy and things then return to normal.
OGTT –2hr test will detect
9lb? Yes No 31% of cases
8. Have suffered high blood pres- What are the effects on mum?
(Oral Glucose Tolerance Test). Only test
sure in a previous pregnancy? Urinary Tract Infections or High blood pres- which can confirm diabetes in preg-
Yes No sure nancy.
9. Have you ever suffered from Pre term labour/increased risk of labour
being induced.+ increased fluid around Fast from 12MN, visit lab 1st blood test
repeated urinary tract infec-
baby taken then given 75g Glucose drink and
further blood test taken 2hrs later.
Yes No Caesarean Section
10. Have you suffered from too and baby?
much amniotic fluid in previous (Oral Glucose Loading Test)
pregnancy? High/low birth weight
Yes No No fasting visit the lab and drink a 50g
Perceived increased risk of shoulder be-
drink of glucose stay at the lab for 1hr
11. Do you come from a Maori, coming stuck during birth.
then have blood taken. A test which is
Asian, Tongan or Samoan Back- Respiratory distress after birth / Jaundice recommended as routine by the Royal
ground? Yes No Australian and New Zealand College of
Reduced blood flow to the placenta giving
Obstetricians and Gynaecologists.
increased risk of stillbirth.