This document discusses classification of diabetes mellitus types based on age of onset, duration, and presence of vascular complications. It also provides guidelines for screening and diagnosing gestational diabetes mellitus between 24-28 weeks of pregnancy based on risk factors. Test results and thresholds for diagnosing diabetes or requiring a glucose tolerance test are defined. Natural family planning methods and sterilization are mentioned as contraception options for those with diabetes.

8. Class
Age at onset
(in years)
Duration Vascular Disease Therapy
A1 GD Any age Any - Diet only
A2 GD Any age Any - Insulin
B Over 20 > 10 yrs None Insulin
C 10-19 10-19 yrs None Insulin
D Before 10 More than
20 yrs
Benign retinopathy Insulin
F Any age Any Nephropathy Insulin
R Any age Any Proliferative
retinopathy
Insulin
H Any age Any Heart disease Insulin
T Any age Any After renal
transplantation
Insulin

10. Altered carbohydrate
metabolism
(hyperglycemia)
MACROSOMI
A
POLYHYDRAMIN
OS

13. Screening and diagnosis
In general, the test is performed between 24-28 weeks
because at this point in gestation the diabetogenic
effect of pregnancy is manifested and there is
sufficient time remaining in pregnancy for therapy to
exert its effect
Screening Risk factors
1. Age>25y
2. BMI > 25
3. Previous GDM
4. Family history of DM in 1st degree relative
5. Previous Macrosomic baby (<4 kg)
6. Polyhydramnios
7. large for date baby in current pregnancy
8. Previous unexplained stillbirth

15. Fasting 2h postprandial result.
<100 mg/dl <145mg/dl Not diabetic.
<145mg/dl 145-200mg/dl Diabetic
100-145 mg/dl 145-200mg/dl Border line indicates
glucose tolerance test

45. Natural Methods
• Highly motivated couples taught to use
these methods correctly, may find this an
effective and acceptable form of
contraception.
– Withdrawal method
– Rhythm method

51. Sterilization
• Recommended to many mothers when their
family is complete.
• The reduced life expectancy of those with
longstanding diabetes should be borne in
mind when making this decision.
• Sterilization is occasionally advised if there
is felt to be a serious risk to the woman’s
health.
• For some couples vasectomy is appropriate