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Gestational Diabetes Care Guidelines

Diagnosis

  • One hour 50 g GCT > 200 mg/dl may be used as an indication to treat for GDM without further testing because it highly correlates with a positive 3-hour 100 g OGTT.
  • The definitive test for GDM is a 3-hour 100 g OGTT in a fasting state after a 3-day carbohydrate loading diet.
  • Use Carpenter and Coustan’s standards for the 3-hour 
  • 100 g OGTT. Abnormal serum/plasma glucose values follow.
3-Hour 100g OGTT

Time

mg/dl

fasting

> or equal to 95

1-hour

> or equal to 180

2-hour

> or equal to 155

3-hour

> or equal to 140

  • Two or more elevated values define GDM.
  • If one elevated value, recommend exercise and nutrition counseling and either repeat 3-hour 100 g OGTT in one month or perform periodic glucose monitoring.
  • 30% of patients with one abnormal value on the 3-hour 
    100 g OGTT will be diagnosed with GDM if retested in 
    4 weeks.
  • All patients with a new diagnosis of GDM should have diabetes education. (See enclosed Gestational Diabetes Care Components).

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