Gestational Diabetes Clinic in the Public Health Setting

Gestational diabetes mellitus (GDM), or "carbohydrate intolerance of variable severity with onset or first recognition during pregnancy," results from insulin resistance and relative insulin deficiency, usually in the second trimester.1 This condition affects between 4 and 9% of all pregnancies.2 With GDM, there are increased fetal complications of macrosomia, shoulder dystocia, and neonatal hyperglycemia, as well as maternal risks of preeclampsia and polyhydramnois.3'4 Also, it has been shown that 33% of GDM patients require Cesarean section compared to 20% of pregnant patients without GDM.5 Women who are of Hispanic or Asian descent are at the highest risk of developing GDM.6 According to the American Diabetes Association (ADA),7 assessment for undiagnosed type 2 diabetes should be completed at the first prenatal visit. [...] the Gestational Diabetes Clinic at the Hall County Health Department is providing diabetes care based on the ADA recommended standards of care for GDM patients, as well as for patients with type 1 or type 2 diabetes, with the goal of preventing fetal and maternal complications.