Gestational diabetes mellitus

Gestational diabetes is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM often precedes a diagnosis of T2DM, occasionally it is a new presentation of T1DM. Management includes a combination of diet, metformin and insulin therapy.

General examination

Cases of screen detected GDM are rarely systemically unwell and there are no specific signs of GDM on general physical examination.

A thorough general and systems examination is still essential in order to detect any complications and to document the patient’s baseline condition.

 

BMI

What is the patient’s BMI? Obesity is an important contributing factor to the pathogenesis of GDM and are also risk factors for other obstetric complications.

Weight management is the central strategy for reducing the risk of T2DM after a GDM pregnancy.

Blood pressure

Is the patient hypertensive?

Cardiovascular, respiratory and abdominal systems

A baseline cardiorespiratory and abdominal examination should be performed and recorded as a routine part of the new patient assessment.

This is to detect any unsuspected comorbidities and/or already established complications in all newly presenting cases of diabetes mellitus.

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