Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about gestational diabetes. And as always you can find written notes on this topic

at zero to finals.com slash gdm or in the antenatal care section of the zero tofinals.com slash gdm or in the antinatal care section of the zero to finals obstetrics and

gynecology book so let's get straight into it gestational diabetes refers to diabetes triggered by

pregnancy is caused by reduced insulin sensitivity during pregnancy and it resolves after birth.

The most significant immediate complication of gestational diabetes is a large for dates fetus and

macrosomia, essentially a large fetus.

This has implications for birth, mainly posing a risk of shoulder dystosia, where the shoulder

gets trapped on the way out.

Longer term, women are at higher risk of developing type 2 diabetes.

Anyone with risk factors for gestational diabetes should be screened with an oral glucose

tolerance test, or OGTT, at 24 to 28 weeks gestation.

Women who have previously had gestational diabetes in a previous pregnancy also have an oral

glucose tolerance test soon after the booking clinic. Let's talk about the risk factors. The

nice guidelines from 2015 list the risk factors that warrant further testing for gestational diabetes.

And these are previous gestational diabetes,

previous macrosomic baby of more than 4.5 kilograms at birth,

a BMI above 30,

certain ethnic backgrounds, specifically Black Caribbean, Middle Eastern and South Asian,

and a family history of diabetes, with one first degree relative.

Let's talk in more detail about the oral glucose tolerance test.

The screening test of choice for gestational diabetes is the oral glucose tolerance test. The screening test of choice for gestational

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