Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • elevated BMI
  • fetal macrosomia

Risk factors

  • advanced maternal age (>40 years)
  • elevated BMI
  • polycystic ovarian syndrome (PCOS)
  • nonwhite ancestry
  • FHx of diabetes mellitus
  • low-fiber and high-glycemic index diet
  • weight gain as young adult
  • physical inactivity
  • previous gestational diabetes

Diagnostic investigations

1st investigations to order

  • one-step test option: 75-gram oral glucose tolerance test (OGTT)
  • two-step test option: 1-hour 50-gram glucose load test (GLT), followed by 3-hour 100-gram OGTT
Full details

Investigations to consider

  • fasting blood (plasma) glucose
  • random blood (plasma) glucose
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Professor of Medicine

Harvard Medical School

Director of Clinical Research

Endocrinology, Diabetes and Hypertension Division

Brigham & Women's Hospital

Boston

MA

Disclosures

EWS declares that she has no competing interests.

Assistant Professor

Department of Obstetrics, Gynecology and Reproductive Biology

Harvard Medical School

Obstetric Director

Diabetes in Pregnancy Program

Brigham and Women’s Hospital

Boston

MA

Disclosures

CZ declares that she has no competing interests.

Dr Ellen W. Seely and Dr Chloe Zera would like to gratefully acknowledge Dr Jeremy Soule and Dr Leonard E. Egede, previous contributors to this monograph. JS has undertaken research support and speakers' bureau activity for Novartis, Bristol Myers Squibb, Astra Zeneca, and Sanofi-Aventis. LEE is an author of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Instructor in Medicine

Brigham and Women's Hospital

Division of Endocrinology

Diabetes and Hypertension

Boston

MA

Disclosures

RKG declares that he has no competing interests.

Clinical Professor

Department of Family Medicine

University of North Carolina

Chapel Hill

Assistant Program Director

MAHEC Rural Family Medicine Residency

Hendersonville

NC

Disclosures

WM declares that he has no competing interests.

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