Sicat GDM

Question 1

Differences between ADA, ACOG, and Endocrine society screening and diagnostic testing for GDM

Answer 1

ADA - 75g OGTT (oral glucose tolerance test)

• Screening: 24-28 wks gestation
• risk factors

ACOG - 50g OGTT -> if positive then 100g OGTT

• Screening: history of GDM or BMI >30
• 24-28 wks gestation

Endo - 75g OGTT

• Screening: Universal screening 13 weeks gestation
• 24-48 wks

Question 2

Which BG monitoring isbetter in GDM?

Answer 2

Postprandial improves glucose control anddecreases rates of neonatal hypoglycemia, macrosomia and cesarean delivery

Question 3

What are BG goals of nonpregnant women? pregnant?

Answer 3

Nonpregnant

Preprandial - 70-130
1 hr postprandial - < 95
1 hr postprandial - <120

Question 4

What drugs can we use to control BG in GDM patients? Which ones cross the placenta?

Answer 4

Insulin (aspart, lispro, levemir)
Metformin –> crosses placenta
Glyburide

Question 5

Which medication has been shown to have good tolerance in GDM patients?

Answer 5

Glyburide

Question 6

According to the primary literature, which is better in use in GDM patients? Metformin or insulin

Answer 6

Metformin had less risk of hypoglycemia and was well tolerated