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Prevalence of MS (%) LGA/GDMAGA/GDMLGA/ConAGA/Con Maternal Fuels Pubertal Altered Fetal Islet Function & ? Epigenetic Modification Impaired Adult Islet Function Obesity effectiveness of diagnosis and treatment! 43 (10%)54 (13%) 62 (16%)55 (15%) Elevated cord 75 (18%)92 (23%) 149 (32%)163 (37%) 3 (1%) 6 (1%) 128 (27%) 154 (34%) 7 (1.5%)18 (4%) The best studies of GDM treatment monitoring; “you manage what you measure.” Daily Home Blood Glucose BW4000 g Cesarean Weekly Daily x 4 P value Erb’spalsy 199 (30%) 232 (34%) 222 (33%) 3 (0.4%) 69 (22%) 73 (23%) 116 (37%) 2 (0.6%) Daily Home Blood Glucose with BS taken 1 hour later Screen all pregnant women @ 24-28 weeks Test earlier in selected patients Use the 100 g oral glucose tolerance test for the diagnosis of GDM No need to test women with 50 g OCT results of 200 mg/dL or greater Experts recommend against using a Diagnosis of Gestational 145140 Women with one abnormal value on the 3 h OGTT are at increased risk for Treat as GDM versus repeat testing in 4 weeks? Glyburide Original Article Enrollment of Subjects Time in Hours Insulin Action Glargine Time in Hours Insulin Action Time in Hours Insulin Action Glargine Time in Hours Insulin Action NPHRegular ~15% of women with GDM have impaired Postpartum Evaluation for