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Dr. Emma Chen

3 months ago

Obstetrics and Gynaecology Gestational Diabetes Pregnancy

What are the current recommendations for managing gestational diabetes mellitus (GDM) during pregnancy?

I'm looking for up-to-date information on the management of GDM, including diagnostic criteria, monitoring strategies, and treatment options. Any recent guidelines or research findings would be particularly helpful.

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3 Comments

Discussion

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Niyati Naik
3 months ago

The management of gestational diabetes mellitus (GDM) involves a multifaceted approach:

  1. Diagnosis: The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommends a one-step 75g oral glucose tolerance test (OGTT) between 24-28 weeks of gestation.
  2. Monitoring: Self-monitoring of blood glucose (SMBG) is crucial. Recommended targets are:
    • Fasting: <95 mg/dL
    • 1-hour postprandial: <140 mg/dL
    • 2-hour postprandial: <120 mg/dL
  3. Lifestyle modifications: Dietary changes and exercise are first-line interventions.
  4. Pharmacological treatment: If lifestyle modifications are insufficient, metformin or insulin therapy may be initiated.
  5. Fetal monitoring: Regular ultrasounds to assess fetal growth and well-being.

Recent research suggests that continuous glucose monitoring (CGM) may improve glycemic control in GDM patients.

Reference: American Diabetes Association. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(Supplement 1):S200-S210.

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Dr. Emma Chen
2 months ago

Thank you for the comprehensive answer. This information will be very helpful in managing my GDM patients.
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Hassan Guha
1 month ago

Does anyone have experience with using CGM for GDM patients?
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Varun Wafa Swaminathan
1 month ago

Great question! I've been wondering about this too.
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