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Type 1 diabetes- absolute insulin deficiency Type 2 diabetes- defective insulin secretion or insulin resistance Fasting plasma glucose

> 126 mg/dl - overt diabetes Ascertain GDM risk: at first prenatal visit Low risk: blood glucose testing not routinely required Average risk: perform blood glucose testing at 24-28 weeks High Risk: perform blood glucose testing as soon as possible (severe obesity, strong family Hx) Perform diabetes screening between 24-28 weeks age of gestation Two-step process: 50-g oral glucose challenge test, ff by diagnostic 100g oral glucose tolerance test 100-glucose tolerance test Fasting: 95 mg/dl, 1 hr: 180 mg/dl, 2hr: 155 mg/dl, 3 hr: 140 mg/dl 75g-glucose tolerance test Fasting: 95 mg/dl, 1 hr: 180 mg/dl, 2hr: 155 mg/dl 2 or more elevated values for a positive diagnosis
Low Risk Member of an ethnic group with a low prevalence of GDM No known diabetes in first-degree relatives Age < 25 years Weight normal before pregnancy Weight normal at birth No history of abnormal glucose metabolism No history of poor obstetrical outcome

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