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-Nearly 4% of
pregnant women in the US have gestational diabetes mellitus (GDM). Diabetes in pregnancy can lead to congenital anomalies,
spontaneous abortions, and macrosomia. Diabetic
pregnant patients need to check blood sugars many times a day including
periodically in the middle of the night to avoid hypoglycemia, which can affect
the baby and also accelerate diabetic retinopathy.
Fasting blood glucose goals 60 to 90-95, one hour postprandial less than
140mg/dl and two hours postprandial less than 140.
-The ADA recommends screening for women with risk factors. It is thought to not be cost effective in patients younger than 25, no family history of diabetes, normal body weight, and not of an ethnic or racial background associated with higher incidence of diabetes. This approach is controversial and some advocate universal screening of all pregnant women. Screening is optimally started between 24-28 weeks gestation. |