This document discusses gestational diabetes, including its diagnosis through a 75g oral glucose tolerance test (OGTT) and risk factors such as BMI over 30 and previous large baby. It describes asking patients to fast overnight before the OGTT to measure fasting blood glucose, then drinking a glucose load and measuring blood glucose again after 2 hours. It notes screening should be offered at 26-28 weeks for those with risk factors or earlier at 16-18 weeks for those with previous gestational diabetes. The risks to mother and fetus are similar to pre-existing diabetes except for miscarriages and anomalies. Diet and exercise may control gestational diabetes.

1. GESTATIONAL DIABETES
DIAGNOSIS
1. 75 g OGTT – gold standard
2. Frank diabetes (pre-diabetes): FBG - >7mmol/L or 2-
hour level of >11.1
3. GDM: FBG - >7 mmol/L or a 2-hour level >7.8
mmol/L
OGTT
Ask the patient to starve the night before the test and will
then have a venous blood glucose level measured (FBG).
Following this, they will be asked to drink 75 g glucose
load and have a second glucose level taken 2 hours later.
RISK FACTORS FOR GDM
1. BMI above 30
2. Previous macrosomic baby > 4.5 kg
3. Previous GDM
4. First degree with DM
5. Country of family origin; South Asia, Black Carribean,
Middle Eastern
OGTT screening
 Pt with one or more RF should be offered an OGTT at
26-28 weeks.
 Pt with previous GDM will be offered an OGTT at 16-
18 weeks.
ANTENATAL CARE
 Risks of GDM to mother and foetus are almost similar
to pre-existing DM except for miscarriages and
congenital anomalies as they have the phase.
 They may respond to changes in diet and exercise
alone
DELIVERY AND POSTNATAL CARE
1. Not as rigid as pre-existing DM.