Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- elevated BMI
- fetal macrosomia
Risk factors
- advanced maternal age (>40 years)
- elevated BMI
- polycystic ovarian syndrome (PCOS)
- non-white ancestry
- family history of diabetes mellitus
- low-fibre and high-glycaemic 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
Investigations to consider
- fasting blood (plasma) glucose
- random blood (plasma) glucose
Treatment algorithm
Contributors
Authors
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
Harvard Medical School
Director, Network Obstetrics Population Health
Division of Maternal Fetal Medicine
Department of Obstetrics and Gynecology
Beth Israel Deaconess Medical Center
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 topic.
Disclosures
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 topic.
Peer reviewers
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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