文档介绍：Gestational diabetes mellitus
Dr. Mohammed Abdalla
Egypt, Domiat General Hospital
Gestational diabetes and impaired glucose tolerance (IGT) in pregnancy affects between of all pregnancies and both have been associated with plications.
2-3%
Fasting and 2 hours postprandial venous plasma sugar during pregnancy.
Border line indicates glucose tolerance test.
125-200 mg/dl.
100-125 mg/dl
Diabetic
>200 mg/ dl.
>125 mg/ dl
Not diabetic
< 145mg/ dl.
<100 mg/dl
Result
2h postprandial
Fasting
Risk assessment
Low-risk status requires no glucose testing, but this category is limited to those women meeting all of the following characteristics:
Age <25 years.
Weight normal before pregnancy .
Member of an ethnic group with a low prevalence of gestational diabetes mellitus .
No known diabetes in first-degree relatives .
No history of abnormal glucose tolerance .
No history of poor obstetric e .
Risk assessment
Risk assessment
marked obesity.
personal history of gestational diabetes mellitus.
Glycosuria.
a strong family history of diabetes .
A high risk of gestational diabetes mellitus:
high risk patients should undergo glucose testing
A fasting plasma glucose level >125mg/dL or a casual plasma glucose >200 mg/dL meets the threshold for the diagnosis of diabetes
In the absence of this degree of hyperglycemia, evaluation for gestational diabetes mellitus in women with average or high-risk characteristics is by glucose tolerance test .
Risk assessment
50-g oral glucose challenge
The screening test for GDM, a 50-g oral glucose challenge, may be performed in the fasting or fed state. Sensitivity is improved if the test is performed in the fasting state .
A plasma value above one hour after monly used as a threshold for performing a 3-hour OGTT.
If initial screening is negative, repeat testing is performed at 24 to 28 weeks.
130 - 140 mg/dl
3 hour Oral glucose tolerance test
Prerequisites:
- Normal diet for 3 days before the test.
- No diuretics 10 da