ACOG Releases Updated Guidance on Gestational Diabetes: What You Need to Know
Gestational diabetes is a condition that affects many pregnant individuals, requiring careful management to ensure the health and well-being of both mother and baby. In January 2023, the American College of Obstetricians and Gynecologists (ACOG) released updated guidance on gestational diabetes, shedding light on the latest recommendations and approaches to managing this condition. In this blog post, we will delve into the key points of ACOG's updated guidance and explore what this means for pregnant individuals and healthcare providers.
Understanding Gestational Diabetes
Gestational diabetes is a type of diabetes that develops during pregnancy, affecting how the body processes sugar (glucose). While it often resolves after giving birth, it can pose risks to both the mother and the baby if not properly managed. Therefore, staying informed about the latest guidelines is crucial for ensuring optimal outcomes.
Key Points from ACOG's Updated Guidance
Screening and Diagnosis:
ACOG emphasizes the importance of early screening for gestational diabetes. The updated guidance provides recommendations on when and how screening should occur, helping healthcare providers identify and manage gestational diabetes in a timely manner.
Currently, the recommendations are to do an oral glucose tolerance test (OGTT) oral at 24-28 weeks of pregnancy. There are a few different ways to do an OGTT that can diagnose GD accurately. ACOG currently recommends the two-step process:
Take 50 grams glucose, and then test blood glucose after 1 hour. This is a screening step, not a diagnosis. If blood glucose is high on step one, proceed to step 2.
Take 100 grams glucose, and then test blood glucose at fasting, 1 hour, 2 hours, and 3 hours. If 2 or more values are high, a GD diagnosis is made.
The second option for gestational diabetes testing is a one-step OGTT. For this test, 75 grams of glucose is consumed, and blood glucose is tested at 1 hou, and 2 hours. As of now, ACOG’s stance is that the singular 2 hour test needs more evidence to be proven beneficial, but can still be utilized in practice. Early screening, usually between 12 and 18 weeks of pregnancy, is recommended if you have multiple risk factors (PCOS, prediabetes, etc).
Management Approaches:
The guidance outlines various approaches to managing gestational diabetes, including lifestyle interventions, such as diet and exercise, as well as pharmacological interventions when necessary. ACOG's recommendations aim to strike a balance between effective management and minimizing potential risks to both the mother and the baby.
It is highly recommended to seek nutrition education or counseling with a registered dietitian as a first line of treatment. Learn about what we offer to help you manage your gestational diabetes at Feed Your Zest here.
If medication is required, know that this is not “bad” in the slightest. ACOG states that insulin is the preferred medication, but metformin is an option too. Talk with your doctor about which might be best for you.
Monitoring and Follow-Up:
ACOG's guidance emphasizes the need for regular monitoring and follow-up throughout pregnancy. This includes ongoing glucose monitoring, check-ups, and adjustments to the management plan as needed. By staying vigilant and responsive, healthcare providers can optimize care and outcomes for pregnant individuals with gestational diabetes.
Checking your blood glucose is a very important part of managing gestational diabetes. ACOG recommends the following blood glucose targets to reduce risks:
<95 mg/dL fasting
<140 mg/dL 1 hour after the first bite of a meal, OR <120 mg/dL at 2 hours
Patient Education:
A significant focus of the updated guidance is on patient education. ACOG encourages healthcare providers to actively engage with pregnant individuals, providing them with the information and support they need to manage gestational diabetes effectively. This empowerment can lead to better compliance with management strategies and improved overall health outcomes.
Historically, many pregnant individuals are left with no information after receiving a gestational diabetes diagnosis, so this is an important guideline update. However, implementation in practice might not be immediate. Here at Feed Your Zest, our goal is to provide weight neutral, flexible, and individualized health education so you don’t have to rely on a Google search to get your answers!
Collaborative Care:
Recognizing the multifaceted nature of gestational diabetes, ACOG underscores the importance of a collaborative approach to care. This involves coordination between obstetricians, endocrinologists, dietitians, and other healthcare professionals to ensure comprehensive and personalized care for pregnant individuals with gestational diabetes.
Care coordination is one of our responsibilities as dietitians when providing comprehensive, effective nutrition care. We’re never afraid to send a letter or give your provider a call.
In conclusion, ACOG's release of updated guidance on gestational diabetes marks a significant step forward in enhancing the care and management of this common pregnancy-related condition.
By staying informed about these guidelines, healthcare providers and pregnant individuals alike can work together to navigate the challenges of gestational diabetes, ultimately promoting the health and well-being of both mother and baby. As we continue to advance our understanding of gestational diabetes, these guidelines serve as a valuable resource for shaping effective and evidence-based care practices.
It's clear that staying informed and proactive is key to managing this condition effectively.
If you or someone you know is navigating gestational diabetes, consider taking the next step towards a healthier pregnancy.
To delve deeper into the intricacies of insulin resistance and gain valuable insights into managing gestational diabetes, we invite you to join our Insulin Resistance Mini Course. This course is designed to provide comprehensive knowledge and practical strategies for individuals at risk for, or currently facing gestational diabetes, WITHOUT shame or restrictive diets. Click here to sign up and take the first step toward a well-managed and informed pregnancy.
For a more personalized approach, our 1:1 coaching program offers tailored guidance and support from experienced professionals. Whether you are seeking assistance with lifestyle modifications, nutritional advice, or overall well-being during pregnancy, our coaching program is designed to meet your unique needs. If you're ready to embark on a journey towards optimal health for you and your baby with a body positive, holistic approach, apply for 1:1 coaching here.
Remember, your health and well-being are of the utmost importance during this crucial time. By taking advantage of these resources, you empower yourself to make informed decisions and foster a positive pregnancy experience. Embrace the support available to you and embark on a path to a healthy and thriving pregnancy journey.