Diagnosis and management of gestational diabetes mellitus

Abstract

The COVID-19 pandemic has required rapid transformation and ada ptation of healthcare services. Women with gestational diabetes mellitus (GDM) are one of the largest high-risk groups accessing antenatal care. In reformulating the care offered to those with GDM, there is a need to balance t he sometimes competing requirement of lowering the risk of direct viral transmission against the potential adv erse impact of service changes. We suggest pragmatic options for screening of GDM in a pandemic setting based on blo od tests, and risk calculators applied to underlying risk factors. Alternative models for antenatal care provision f or women with GDM, including targeting high-risk groups, early lifestyle interventions and remote monitoring are provide d. Testing options and their timing for postpartum screening in women who had GDM are also considered. Our suggest ions are only applicable in a pandemic scenario, and usual guidelines and care pathways should be re-implemented as soon as possible and appropriate.