Gestional Diabetes Mellitus

Gestational Diabetes Mellitus:

Screening for gestational diabetes All women at high risk should have an oral glucose tolerance test at 24-28 weeks.

Measurement of HbAlc and/or blood glucose at booking visit is usually recommended.

Risk factors for gestational diabetes:

• 1. Body mass index> 30 kg/m2
• 2. Previous macrosomic baby weighing>4.5kg
• 3. Previous gestational diabetes
• 4. Family history of diabetes (first degree relative with diabetes)
• 5. Family origin with a high prevalence of diabetes:
• a) South Asian (specifically women whose country of family origin is India, Pakistan or Bangladesh)
• b) Black Caribbean

Investigations:

• 1)FBS& 2HABF 
• 2)HbA1c
• 3)CUS
• 4)Urine RME

Managenment

• Reduce intake of refined carbohydrate, and
• add metformin, glibenclamide and/or insulin
• if necessary to optimise glycaemic control.

➡️If 2HABF : 11.1--16.7 mmmol/L 

• Tab.Comet (metformin)(500mg)...1+0+1......(After meal).... চলবে 

➡️If 2HABF: >16.7 mmol/L

Inj.Insulin

 🙏Referred To Endocrinologist 

🎴Targets are-

• Pre-prandial level of less then 5.3 mmol/L (95mg/dL) and
• 1 hour or 2 hour post prandial level of less then 7.8mmol/L (140 mg/dL) and less then 6.4 mmol/L (114mg/dL), respectively.

Follow up:

Fasting blood glucose measured at 6 weeks

post-partum and has HbAlc concentrations

measured annually to screen for the

development of diabetes.