For the purpose of this guideline Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance occurring in pregnancy which returns to normal after delivery of baby. Around 2 - 5% of women in our population will develop GDM. The International Association of Diabetes and Pregnancy Study Group’s consensus document suggests that all women at high risk should be offered screening with HbA1c, fasting or random glucose at the first gestational visit 1. Highland Health has adopted the recommendations for screening for GDM according to SIGN Guideline 116, 2010 2 .
An important aim of screening, particularly in early pregnancy, is to identify women with undiagnosed type 2 diabetes and those with rarer forms of diabetes such as Maturity Onset Diabetes of the Young (MODY). Clinical suspicion of pre existing diabetes may be raised by persistent heavy (2+) glycosuria in pregnancy on more than 2 occasions, random glucose >5.5 two hours or more after food, or >7.0 within two hours of food.
Randomised control trials have shown that intervention in women with gestational diabetes with dietary advice, monitoring and management of blood glucose is effective in reducing birth weight, and the incidence of large for gestational age infants, and perinatal morbidity 1,3,4,5.
For management of GDM in pregnancy please see the separate guideline NHS Highland Screening, Diagnosis and Management of Gestational Diabetes in Pregnancy.