Screening for diabetes during pregnancy

A substantial proportion of women of child bearing age develop gestational diabetes mellitus (GDM). GDM is defined as diabetes which is first detected during pregnancy. In order to prevent maternal and prenatal complications of diabetes, early detection of glucose tolerance abnormalities during pregnancy is important. Another advantage is screening for GDM is the fact that women who develop glucose intolerance during pregnancy will run higher risk of developing diabetes in the future; thus, detection of this abnormality provides the possibility of preventive intervention.

⦁ Screening is recommended at two stages during pregnancy: All pregnant women should be screened for diabetes during the first antenatal visit by testing for glycosuria. A positive test is an indication for further assessment by a 75 g oral glucose tolerance test.
⦁ At 24-28 weeks of gestation, women at high risk of developing GDM or IGT should be screened by means of an oral glucose tolerance test, using 75 g glucose load.
Those at high risk include women with:
⦁ Previous GDM or IGT
⦁ A family history of diabetes
⦁ Obesity
⦁ Adverse obstetric history
⦁ History of giving birth to a big baby
⦁ History of congenital malformation affecting the newborn in previous pregnancy
The WHO criteria for the diagnosis of glucose tolerance abnormalities can be used during the pregnancy.

Management

Good glycaemia control has special importance during pregnancy. Maternal and prenatal complications can be reduced if good control is achieved before and during conception. Good biochemical control before pregnancy is important since hyperglycaemia seems to be a major factor in the development of congenital malformations and the risk of these malformations is highest during the first eight weeks of gestation.
Guidelines for the management of diabetes during pregnancy..........

For more details....... http://www.humblemedicals.com/2018/12/diabetes-and-pregnancy.html