Screening and management of diabetes discovered during pregnancy

Abstract

Diabetes discovered during pregnancy, or gestational diabetes mellitus (GDM), requires strict control and close monitoring to ensure a normal outcome. Diagnosis in groups of women who are ‘at risk’ is important. This is particularly relevant if pregnant women are considering shared care with their primary care team. Who should be screened, when and how, has been a much debated question. Practice nurses and midwives play an important role in the screening process, and should be aware of the features of ‘at risk’ women. At risk factors include obesity, previous large baby, family history of diabetes mellitus (DM), older women, certain ethnic groups and a previous adverse obstetric outcome. Combined obstetric and diabetes management provides the most effective means of controlling blood glucose levels, and therefore the best outcome of pregnancy. Follow up of these women by the primary care team is recommended because there is an increased risk of established diabetes mellitus developing later in life.