HealthDay News — All pregnant women should be tested for diabetes before 13 weeks gestation, according to new clinical practice guideline for managing the condition in pregnant patients.

Ian Blumer, MD, from the Charles H. Best Diabetes Centre in Whitby, Canada, and colleagues developed the evidence-based guideline using the Grading of Recommendations, Assessment, Development and Evaluation system to address important clinical issues in the management of women with diabetes during pregnancy. It was published in the Journal of Clinical Endocrinology & Metabolism

A fasting plasma glucose level of 92 to 125 mg/dL should be used as the diagnostic criteria for gestational diabetes , with ≥126 mg/dL indicative of overt diabetes, the guidelines specify. 

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Those not previously identified as having diabetes should undergo gestational diabetes testing with a 75-g oral glucose tolerance test (OGTT) at 24 to 28 weeks gestation.

Initial treatment of gestational diabetes should include medical nutrition therapy and moderate daily exercise. Obese women with overt or gestational diabetes should reduce their calorie intake. If lifestyle therapy is insufficient to maintain normoglycemia, blood glucose-lowering pharmacotherapy should be initiated.

Women who have had gestational diabetes should undergo an OGTT six to 12 weeks after delivery to rule out prediabetes or diabetes. All women who have had gestational diabetes should undergo lifestyle management counseling to reduce the risk of type 2 diabetes, as well as regular diabetes screening, especially before future pregnancies.

“The guideline synthesizes evidence-based strategies to support women who have diabetes during pregnancy,” Blumer said in a statement.


  1. Blumer I et al. J Clin Endocrinol Metab. 2013;98(11): 4227-4229.