Gestational diabetes secondary prevention

Following delivery, mothers diagnosed with GDM should have close follow ups to prevent overt diabetes in future. Testing with 75 g OGTT 6 to 12 weeks after delivery, and then every 1-3 years is recommended for early diagnosis of diabetes.

• The OGTT is recommended over A1C at the 6 to 12 week postpartum visit because A1C may be persistently impacted (lowered) by the increased red blood cell turnover related to pregnancy or blood loss at delivery.
• GDM is associated with increased maternal risk for diabetes. Following delivery, women should be tested every 1–3 years ( if a 6 to 12 week 75-g OGTT is normal), with the frequency of screening depending on other risk factors such as family history of DM, prepregnancy BMI, and need for insulin or oral glucose lowering medications during pregnancy.
• Continuous screening may also be performed with any recommended glycemic test (e.g., hemoglobin A1C, fasting plasma glucose, or 75-g OGTT using nonpregnant thresholds).^[1]

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