diagnostic criteria for diabetes mellitus the criteria for the diagnosis of diabetes are shown in table 2.three way to diagnose diabetes are possible, and each, in the absence of unequivocal hyperglycemia,must be confirmed,on a subsequent day,by any one of the three methods given in Table 2. The use of the hemoglobin A1C for the diagnosis of diabetes is not recommended at this time.diagnosis of GDMThe criteria for abnormal glucose tolerance in pregnancy are those of Carpenter and Coustan (3). Recommedations from the American Diabetes Association's Fourth International Workshop Conference on Gestational Diasbetes Mellitus held in March 1997 support the use of Carpenter/Coustan diagnostic criteria as well as the alternative use of a diagnostic 75 g. 2hr. OGTT. These criteria are summarized below.Testing for gestational diabetes. Previous recommendations included screening for GDM performed in all pregnancies.However, there are certain factors that place women at lower risk for the development of glucose intolerance during pregnancy, and it is likely not cost effective to screen such patients.Pregnant women who fulfill all of these criteria need not be screened for GDM. This low-risk group comprises women who-are <25 years of age.-are a normal body weight-have no family history (i.e.,first-degree relative) of diabetes-have no history of abnormal glucose metabolism-have no history of poor obstetric outcome-are not members of an ethnic/racial group with a high prevalence of diabetesRisk assessment for GDM should be undertaken at the first prenatal visit. Women with clinical characteristics consistent with a high risk of GDM(marked obesity, personal history of GDM, glyco suria, or a strong family history of diabetes) should undergo glucose testing(see below) as soon as feasible. if they are found not to have GDM at that initial screening, they should be retested between 24 and 28 week of gestation.Women of average risk should have testing undertaken at 24-28 weeks of gestation.
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