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Uptodate Reference Title
Initial approach to glucose management in patients with newly diagnosed gestational diabetes mellitus at 24 to 28 weeks of gestation
Initial approach to glucose management in patients with newly diagnosed gestational diabetes mellitus at 24 to 28 weeks of gestation
This is an overview of the approach to managing glucose levels in patients with GDM. Refer to UpToDate content on medical nutritional therapy, exercise, glucose monitoring, and insulin dosing in GDM for more detailed guidance.
GDM: gestational diabetes mellitus; AC: abdominal circumference; EFW: estimated fetal weight. * In individualized cases, the frequency of blood glucose monitoring may be reduced in patients with mild GDM (defined as no more than intermittent glucose elevations within 5 to 10 points above targets) and no signs of fetal overgrowth or polyhydramnios. ΒΆ Metformin immediate release can be used instead of the extended release preparation. Glyburide is an alternative to metformin; however, concerns have been raised that it is more often associated with adverse neonatal outcomes, including macrosomia and hypoglycemia. Both the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine suggest metformin over glyburide when choosing to start an oral hypoglycemic agent in pregnancy.
