Key Points

• Outcome of diabetic pregnancy depends on the mother's glucose levels, duration of DM before pregnancy, diabetic complications (nephropathy, retinopathy, vascular disease), and age at conception.

• Because of the increasing prevalence of DM, all pregnant women, except those in low-risk groups, should be screened for diabetes.

• Screening for gestational diabetes is performed at 24 to 28 weeks' gestation with 50-g oral glucose load and blood glucose measured 1 hour later (abnormal: >130 mg/dL).

• Diagnosis of GDM is confirmed by an oral glucose tolerance test. Glucose values are determined fasting and at 1, 2, and 3 hours (normal: <95, <180, <155, and <140 mg/dL, respectively; two higher values make diagnosis).

• The patient with GDM is advised of lifetime risk of diabetes and preventive effects of diet and exercise.

Diabetic pregnancies include gestational diabetes mellitus, which is the development of hyperglycemia during pregnancy, and pregnancy in women with prior history of type 1 or type 2 diabetes.

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