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1. Gestational Diabetes

Gestational Diabetes © 2002 Kaiser Foundation Health Plan of Washington. All rights reserved. 1 Gestational Diabetes Screening and Treatment Guideline Major Changes as of April 2018 2 Screening Recommendations and Tests 2 Diagnosis 3 Treatment Goals 3 Lifestyle modifications/non-pharmacologic options 3 Pharmacologic options 4 Additional Testing/Monitoring Antenatal monitoring 7 Follow-up after delivery 7 Referral 7 Evidence Summary 8 References 11 Guideline Development Process and Team 12 Last (...) in the guidelines may not be appropriate for use in all circumstances. The inclusion of a recommendation in a guideline does not imply coverage. A decision to adopt any particular recommendation must be made by the provider in light of the circumstances presented by the individual patient. 2 Major Changes as of April 2018 New Previous 2-step gestational diabetes (GDM) screening test 1-step GDM screening test Follow Canadian Diabetes Association blood glucose cutoffs for diagnosis: • Fasting = 95 mg/dL or • 1

2018 Kaiser Permanente Clinical Guidelines

2. Gestational Diabetes Mellitus

Gestational Diabetes Mellitus Sign In (ACOG) Sign in to your ACOG account Email is required. Please enter valid Email. was not found in our system. Would you like to associated with your account? Forgot your email address? JSOG Member? © 2019 - American College of Obstetricians and Gynecologists

2018 American College of Obstetricians and Gynecologists

3. SMFM Statement Pharmacological treatment of gestational diabetes Full Text available with Trip Pro

SMFM Statement Pharmacological treatment of gestational diabetes SMFM Statement: Pharmacological treatment of gestational diabetes - American Journal of Obstetrics & Gynecology Email/Username: Password: Remember me Search Terms Search within Search Share this page: Access provided by Volume 218, Issue 5, Pages B2–B4 SMFM Statement: Pharmacological treatment of gestational diabetes Society of Maternal-Fetal Medicine (SMFM) Publications Committee ∗ Society for Maternal-Fetal Medicine, Washington (...) , DC DOI: | Publication History Published online: February 03, 2018 Expand all Collapse all Treatment for gestational diabetes mellitus (GDM) is associated with improved perinatal outcomes that include reduced frequency of hypertensive disorders of pregnancy, delivery of a large-for-gestational-age (LGA) infant, shoulder dystocia, and cesarean delivery. x 1 Landon, M.B., Spong, C.Y., Thom, E. et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med . 2009

2018 Society for Maternal-Fetal Medicine

4. Screening and Diagnosis of Gestational Diabetes Mellitus*

Screening and Diagnosis of Gestational Diabetes Mellitus* Screening and Diagnosis of Gestational Diabetes Mellitus | National Guideline Clearinghouse success fail JUL Aug 12 2018 2019 30 Sep 2016 - 13 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive-It Team) is a rogue archivist collective dedicated to saving copies of rapidly dying or deleted websites for the sake of history and digital heritage. The group is 100% composed (...) In Username or Email * Password * Remember Me Don't have an account? The AHRQ National Guideline Clearinghouse (NGC, guideline.gov) Web site will not be available after July 16, 2018 because federal funding through AHRQ will no longer be available to support the NGC as of that date. For additional information, read our . Guideline Synthesis Screening and Diagnosis of Gestational Diabetes Mellitus Guidelines Being Compared: The Endocrine Society (Endocr Soc) Diabetes and pregnancy: an Endocrine Society

2014 National Guideline Clearinghouse (partial archive)

5. Gestational Diabetes Mellitus, Screening

Gestational Diabetes Mellitus, Screening Final Update Summary: Gestational Diabetes Mellitus, Screening - US Preventive Services Task Force Search USPSTF Website Text size: Assembly version: 1.0.0.308 Last Build: 11/16/2018 6:27:19 PM You are here: Final Summary Gestational Diabetes Mellitus, Screening Release Date: January 2014 This topic is in the process of being updated. Please go to the section to see the latest documents available. Recommendation Summary Summary of Recommendations (...) and Evidence Population Recommendation Grade Asymptomatic Pregnant Women, After 24 Weeks of Gestation The USPSTF recommends screening for gestational diabetes mellitus (GDM) in asymptomatic pregnant women after 24 weeks of gestation. Asymptomatic Pregnant Women, Before 24 Weeks of Gestation The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for GDM in asymptomatic pregnant women before 24 weeks of gestation. ( ) Related Information

2014 U.S. Preventive Services Task Force

6. Recommendations for practices utilizing gestational carriers: a committee opinion

history xii. Sexual and reproductive history xiii. Historyofsmoking,substanceuse,andphysical, emotional, or sexual abuse xiv. Historyofpostpartumdisorder(s)andotherunre- solved negative reproductive events xv. Religious beliefs that may in?uence behavior xvi. Maturity, judgment, assertiveness, and decision- making skills xvii. Legal history xviii. Negative medical history as it relates to the psy- chosocial adjustment of being a gestational car- rier (e.g., bed rest, gestational diabetes, preeclampsia (...) Recommendations for practices utilizing gestational carriers: a committee opinion Recommendations for practices utilizing gestational carriers: a committee opinion Practice Committee of the American Society for Reproductive Medicine and Practice Committee of the Society for Assisted Reproductive Technology American Society for Reproductive Medicine, Birmingham, Alabama This document provides the latest recommendations for evaluation of gestational carriers and intended parents. It incorporates

2017 Society for Assisted Reproductive Technology

7. Multiple Gestations

, complicating 14% to 17% of triplet pregnancies. In general, the prognosis of the surviving twin is excellent when co-twin demise occurs early in pregnancy. However, some studies have found a higher frequency of complications compared to singletons, including gestational diabetes, growth ACR Appropriateness Criteria ® 9 Multiple Gestations restriction, low birth weight, and perinatal mortality [87,88] with an overall 50% to 80% of surviving twins being born preterm. Survivors of a monochorionic pregnancy (...) Multiple Gestations Revised 2017 ACR Appropriateness Criteria ® 1 Multiple Gestations American College of Radiology ACR Appropriateness Criteria ® Multiple Gestations Variant 1: Known or suspected multiple gestations. Monochorionic or dichorionic. First trimester US. Procedure Appropriateness Category Relative Radiation Level US pregnant uterus transvaginal Usually Appropriate O US pregnant uterus transabdominal Usually Appropriate O US cervix transvaginal Usually Not Appropriate O US duplex

2017 American College of Radiology

8. Management of Type 2 Diabetes Mellitus

complications. Key points Prevention. In individuals at risk for type 2 diabetes (see Table 1), type 2 diabetes can be delayed or prevented through diet, exercise, and pharmacologic interventions [IA]. Screening. Although little evidence is available on screening for diabetes, screening should be considered every 3 years beginning at age 45 or annually at any age if BMI = 25 kg/m 2 [evidence: IID], history of hypertension [IIB], gestational diabetes [IC], or other risk factors. Diagnosis. An A1c of 6.5 (...) ) should be screened for diabetes (USPSTF level B recommendation). In adults who have hypertension and diabetes, lowering blood pressure below conventional target values reduces the incidence of cardiovascular events and cardiovascular mortality and justifies screening. Screening may be reasonable for other at-risk subjects (e.g., those with obesity, history of gestational diabetes mellitus, family history, and high-risk ethnic minorities). Based on expert opinion the ADA recommends considering earlier

2020 University of Michigan Health System

9. Management of Diabetes Mellitus in Primary Care

. The insulin resistance resulting in T2DM is thought to be due to excess adiposity, especially central distribution of adiposity, but can be due to other factors, such as corticosteroid treatment or Cushing’s syndrome. Gestational diabetes (GDM) is DM present during pregnancy. Other more unusual types of DM also exist, such as maturity onset diabetes of the young (MODY), latent VA/DoD Clinical Practice Guideline for the Management of Type 2 Diabetes Mellitus in Primary Care April 2017 Page 6 of 160 (...) Management of Diabetes Mellitus in Primary Care VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS IN PRIMARY CARE Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision-making. They are not intended to define a standard of care

2017 VA/DoD Clinical Practice Guidelines

10. Multiple gestation associated with infertility therapy: a committee opinion

no association between the type of culture medium and risk of monochorionic twinning (the subclassi?cation of monozygotic twinning in which twins share a chorion), but did observe a 24-fold increased risk in cycles involving both ICSI and extended culture (23). COMPLICATIONSOFMULTIPLEGESTATIONS Multiple gestation increases maternalmorbidity and bothfe- talandneonatalmorbidityandmortality.Themostimportant maternalcomplicationsassociatedwithmultiplegestationare preeclampsia, gestational diabetes, and preterm (...) to the consequences of preterm birth (Table 1). Even singleton births after ART are associated with in- creasedrisks,suchasprematurity,independentlyfrommater- nalageandfetalnumbers(35–38),buttherisksarefargreater withmultiplegestations.Therisksforfetaldemiseduringthe third trimester, perinatal mortality, preterm birth, and both low ( 22 weeks: OR 9.09, 95% CI 1.72–50) (50). The incidences of preterm birth ( 60 Gestational diabetes 3 5–87 >10 Preterm labor 15 40 75 >95 Delivery at 95 Delivery at 95 Practice

2012 Society for Assisted Reproductive Technology

11. Gestational diabetes mellitus (GDM). Evidence-based nutrition practice guideline.

Gestational diabetes mellitus (GDM). Evidence-based nutrition practice guideline. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding

2010 American Dietetic Association

12. Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening

who are seen in primary care settings and do not have obvious symptoms of diabetes. Persons who have a family history of diabetes, have a history of gestational diabetes or polycystic ovarian syndrome, or are members of certain racial/ethnic groups (that is, African Americans, American Indians or Alaskan Natives, Asian Americans, Hispanics or Latinos, or Native Hawaiians or Pacific Islanders) may be at increased risk for diabetes at a younger age or at a lower body mass index. Clinicians should (...) Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening Final Update Summary: Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening - US Preventive Services Task Force Search USPSTF Website Text size: Assembly version: 1.0.0.308 Last Build: 11/16/2018 6:27:19 PM You are here: Final Summary Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening Release Date: October 2015 This topic is in the process of being updated. Please go to the section to see the latest documents

2015 U.S. Preventive Services Task Force

13. Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus Full Text available with Trip Pro

medications and lifestyle. In addition, there is discussion about risk factors that are specific to women, including gestational diabetes mellitus (GDM) and polycystic ovarian syndrome (PCOS), which affect CVD risk. focuses on sex differences in CVD risk factors and outcomes in DM, and provides information about sex differences in CVD treatments and interventions in DM. contains some of the important ideas for research in sex differences in the cardiovascular consequences of DM. Table 1. Sex Differences (...) power to assess sex differences in post hoc analyses of lifestyle intervention studies. ACE indicates angiotensin-converting enzyme; CHD, coronary heart disease; CVD, cardiovascular disease; DM, diabetes mellitus; GDM, gestational diabetes mellitus; PAD, peripheral arterial disease; PCOS, polycystic ovary syndrome; RCT, randomized, controlled trial; and T2DM, type 2 diabetes mellitus. Sex Differences in the Hormonal Milieu Between Women and Men: Could They Differentially Influence Coronary Risk

2015 American Heart Association

14. Management of Newly Diagnosed Type 2 Diabetes Mellitus (T2DM) in Children and Adolescents

Collaboration, and Embase. MESH terms used in various combinations in the search included diabetes, mellitus, type 2, type 1, treatment, prevention, diet, pediatric, T2DM, T1DM, NIDDM, metformin, lifestyle, RCT, meta-analysis, child, adolescent, therapeutics, control, adult, obese, gestational, polycystic ovary syndrome, metabolic syndrome, cardiovascular, dyslipidemia, men, and women. In addition, the Boolean operators NOT, AND, OR were included in various combinations. Articles addressing treatment (...) Management of Newly Diagnosed Type 2 Diabetes Mellitus (T2DM) in Children and Adolescents Management of Newly Diagnosed Type 2 Diabetes Mellitus (T2DM) in Children and Adolescents | From the American Academy of Pediatrics | Pediatrics '); document.write(''); } function OAS_AD(pos) { if (OAS_version >= 11 && typeof(OAS_RICH)!='undefined') { OAS_RICH(pos); } else { OAS_NORMAL(pos); } } //--> Search for this keyword Source User menu Sections Sign up for highlighting editor-chosen studies

2013 American Academy of Pediatrics

15. Clinical Care Guidelines for Cystic Fibrosis-Related Diabetes

of the pregnancy if they have not had an OGTT in the previous 6 months. Because women with CF are at high risk for development of hyperglycemia during pregnancy (gestational diabetes mellitus), the 2-h 75-g OGTT should be performed at the end of both the first and second trimesters. Women with CF who are planning a pregnancy or confirmed pregnant should be screened for preexisting CFRD with a 2-h 75-g fasting OGTT if they have not had a normal CFRD screen in the last 6 months. (ADA-E; Consensus) Screening (...) for gestational diabetes mellitus is recommended at both 12–16 weeks' and 24–28 weeks' gestation in pregnant women with CF not known to have CFRD, using a 2-h 75-g OGTT with blood glucose measures at 0, 1, and 2 h. (ADA-E; Consensus) Screening for CFRD using a 2-h 75-g fasting OGTT is recommended 6–12 weeks after the end of the pregnancy in women with gestational diabetes mellitus (diabetes first diagnosed during pregnancy). (ADA-E; Consensus) Screening CF patients undergoing transplantation

2010 Cystic Fibrosis Foundation

16. Prenatal Care

with a history of prior preeclampsia, diabetes, chronic hypertension, renal disease, autoimmune disorder, or multiple gestation. Treatment with low-dose aspirin (81 mg by mouth once daily) beginning at 12 weeks’ gestation is recommended to reduce the risk for development of preeclampsia in these patients. Routine aspirin prophylaxis has not been shown to be beneficial in low-risk patients. Gestational hypertension and preeclampsia without severe features are indications for sonographic evaluation of fetal (...) of undiagnosed diabetes, as well as those with a history of gestational diabetes (GDM), a first degree relative with diabetes, or other risk factors (eg, age = 35, BMI = 30, inactive lifestyle, prior macrosomic infant, prediabetes, or PCOS). A reasonable approach is to evaluate Fasting Plasma Glucose (FPG) and A1c. The results are interpreted as: • FPG = 126 mg/dL or A1c = 6.5 is diagnostic of overt diabetes. • FPG = 95 mg/dL, but 38 degrees Celsius (100.4 degrees Fahrenheit) when GBS screening culture

2020 University of Michigan Health System

17. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion

embryos, and adoption. The patient's current state of health must be considered, as some individuals with severely debilitatingcancersmaybetooill tosafelyundergofertility- preservation procedures. In addition, the potential safety of futurepregnancyaftercancerinwomenshouldbeaddressed, taking into account the type of cancer and proposed treat- ment. The possibility of gestational surrogacy should be re- viewed with all female patients, particularly those who have (...) , fever, and malnutrition. Somemen,especiallyyoungteenagers,maybeunableto ejaculate by masturbation. Counseling and a comfortable environment to collect may be helpful (107). Pubertal status aswellasavarietyoffactorsrelatedtocancercancontribute to this condition, including anxiety, fatigue, hypogonadism, pain, comorbidities such as diabetes, neurologic problems, andsideeffectsfromavarietyofmedicationssuchasopioids and antidepressants, as well as the underlying disease itself. For theseyoung men

2020 Society for Assisted Reproductive Technology

18. Treatment of Patients with Schizophrenia

, and physical conditions, such as cardiovascular, respiratory, and infectious diseases and malignancies, particularly lung cancer (American Psychiatric Association 2013a; Hayes et al. 2017; Heilä et al. 2005; Hjorthøj et al. 2017; Laursen et al. 2014; Lee et al. 2018; Oakley et al. 2018; Olfson et al. 2015; Tanskanen et al. 2018; Walker et al. 2015). Increases in morbidity and mortality related to physical health in individuals with schizophrenia are likely associated with factors such as obesity, diabetes

2020 American Psychiatric Association

19. Macrosomia

) 4,500–4,999 g, and 3) more than 5,000 g. Frequency of Occurrence Data from the National Center for Health Statistics show that 7.8% of all live-born newborns in the United States weigh 4,000 g or more (6). Only 1% weigh more than e18 VOL. 135, NO. 1, JANUARY 2020 OBSTETRICS & GYNECOLOGY4,500 g and 0.1% more than 5,000 g. The rate of new- borns weighing at least 4,000 g has decreased in the United States from the reported rate of 10% in 1996 (7). Women with gestational diabetes mellitus (GDM (...) ) or obesity have higher rates of LGA newborns (8, 9). In a study of nearly 10,000 women, the rate of LGA newborns without GDM was 7.7% in normal-weight women and 12.7% in obese women. In women with GDM, the rates were 13.6% in normal-weight women and 22.3% in obese women (9). Risk Factors for Macrosomia A variety of maternal factors predispose a newborn to macrosomia, including constitutional factors, preexisting diabetes and GDM, maternal prepregnancy obesity, exces- sive gestational weight gain

2020 American College of Obstetricians and Gynecologists

20. Prenatal Care

at the initial prenatal visit for all pregnant women to determine gestational age and identify multiple gestations, and will be available at all KPWA primary care clinics by the end of 2018. Previously, ultrasound was not available at all KPWA primary care clinics, so some women were sent to Radiology for this service. We now recommend using the 2-step screening test for gestational diabetes (GDM). Previously, we recommended using the 1-step screening test for GDM. Note: The Prenatal Care Screening (...) for a Pap test Thyroid-stimulating hormone (TSH) testing 5 Women with diagnosed hypothyroidism only. Routine screening not recommended Drug misuse screening, DAST-10 Women in whom there is clinical suspicion of drug misuse 1 If HbA1c is negative but diabetes is suspected due to symptoms, BMI, or ultrasound findings, a two-step screening test for gestational diabetes is recommended. See the Gestational Diabetes Guideline. 2 See the Depression Guideline. 3 Any alcohol use is unhealthy in pregnancy. See

2018 Kaiser Permanente Clinical Guidelines