Recommendations: Detection and Diagnosis of GDM (2)
Recommendations for the detection and diagnosis of gestational diabetes mellitus (GDM)1 are summarized on two slides; this slide (Slide 2 of 2) includes: Screen women with GDM for persistent diabetes at 6–12 weeks’ postpartum, using the OGTT and nonpregnancy diagnostic criteria (E) Women with a history of GDM should have lifelong screening for the development of diabetes or prediabetes at least every 3 years (B) Women with a history of GDM found to have prediabetes should receive lifestyle interventions or metformin to prevent diabetes (A) Women with a history of GDM have a greatly increased subsequent risk for diabetes2; therefore, they should be screened for diabetes 6–12 weeks postpartum, using nonpregnant OGTT criteria, and followed for the development of diabetes or prediabetes (see Section II. Testing for Diabetes in Asymptomatic Patients) Because of their prepartum treatment for hyperglycemia, use of the A1C for diagnosis of persistent diabetes at the postpartum visit is not recommended3 Lifestyle interventions or metformin should be offered to women with a history GDM who develop prediabetes (see Section IV. Prevention/Delay of Type 2 Diabetes) For information on the National Diabetes Education Program campaign to prevent type 2 diabetes in women with GDM, see http://ndep.nih.gov/media/NeverTooEarly_Tipsheet.pdf18References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S15-S16. Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 2002;25:1862-1868. Kim C, Herman WH, Cheung NW, Gunderson EP, Richardson C. Comparison of hemoglobin A1c with fasting plasma glucose and 2-h postchallenge glucose for risk stratification among women with recent gestational diabetes mellitus. Diabetes Care 2011;34:1949-1951.