Testing for GDM:
• Current standard of care is to investigate all pregnancies with oral glucose challenge test

Glucose Challenge Test (GCT):
• no preparation required and no fasting prior to test needed
• 50g oral glucose load is given
• wait one hour after drink with no eating or drinking during this time, then draw blood for glucose test
• blood glucose <7.8 is considered a negative screen
• if result is 11.1 mmol/L, gestation diabetes is present
• if value is between 7.8 and 11.0, follow with glucose tolerance test

Glucose Tolerance Test (GTT):
• patient must fast from night before
• fasting blood sugar drawn in the morning
• 75g oral glucose load is given
• blood is drawn again 1 and then 2 hours after the drink is completed
• Abnormal for 75g 2-hour GTT:
---1 . FBS ≥ 5.3 mmol/L
---2 . 1-hour ≥ 10.6 mmol/L
---3 . 2-hour ≥ 9.0 mmol/L
• one abnormal value = GDM
Postpartum:
• Ensure postpartum follow-up: pts with GDM should have a GTT between 6wks and 6 months postpartum, with appropriate follow-up with endocrinology or their family doctor
• Patients with GDM have a very high risk of developing future DMII: may be impetus to improve diet and lifestyle