Gestational Diabetes Clinic for Indigent Latinos

Gestational diabetes mellitus (GDM), “carbohydrate intolerance of variable severity with onset or fist recognition during pregnancy,” results from insulin resistance and relative insulin deficiency usually in second trimester.¹ • Gestational diabetes (GDM) impacts between 4% and 9% of all pregnancies. • Gestational diabetes (GDM) results in increased fetal complications of macrosomia, shoulder dystocia and neonatal hyperglycemia as well as maternal risks of preeclampsia and polyhydramnois. • Women who are Hispanic or Asian decent are at highest risk of developing GDM. • Diagnosis ² • Perform 75-gramoral glucose tolerance test (OGTT) at 24 – 28 weeks of gestation in women not previously diagnosed with diabetes • Diagnosis of GDM made when any of the following values are exceeded: • Fasting ≥ 92 mg/dL • 1 hour ≥ 180 mg/dL • 2 hour ≥ 153 mg/dL • Upon diagnosis of gestational diabetes, medical nutrition therapy, self-monitoring of blood glucose and fetal monitoring are initiated. • Both Landon and Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) studies support active management of gestational diabetes even in the mild form to decrease fetal complications.