|
| | ACOG 2013 [4] | CDA 2013 [10] | ADA 2015 [9] | FIGO 2015 [5] | NICE 2015 [11] |
|
| Criteria to start therapy after diet alone | Inconclusive evidence | Glycemic control not achieved after 2 weeks of nutritional therapy alone | NR | NR | Glycemic control not achieved after 1-2 weeks of diet and exercise |
|
| Type of initial therapy | Insulin or oral medications | Insulin or oral medications | Insulin or glyburide | Glyburide inferior to both insulin and metformin,
while metformin performs
better than insulin | Metformin |
|
| Dose and frequency of initial therapy | NR | NR | NR | NR | NR |
|
| Frequency of glucose monitoring | 4 times
daily as fasting
and either 1 h or 2 h after each meal | 4 times
daily as fasting
and either 1 h or 2 h after each meal | NR | 4 times
daily as fasting
and 2 h after each meal | 7 times
daily as fasting, premeal, 1 h after each meal, bedtime |
|
| Target glucose values | 1 h ≤ 140 mg/dL,
2 h ≤ 120 mg/dL
| Fasting ≤ 95 mg/dL, 1 h ≤ 140 mg/dL,
2 h ≤ 120 mg/dL | Fasting ≤ 95 mg/dL, 1 h ≤ 140 mg/dL,
2 h ≤ 120 mg/dL | Fasting ≤ 95 mg/dL, 1 h ≤ 140 mg/dL,
2 h ≤ 120 mg/dL | Fasting ≤ 95 mg/dL, 1 h ≤ 140 mg/dL,
2 h ≤ 116 mg/dL |
|
| Criteria for pharmacologic therapy dose adjustment | NR | NR | NR | NR | NR |
|
| Criteria for adding or switching pharmacologic therapy | NR | NR | NR | NR | NR |
|
| Pregnancy monitoring | No consensus | NR | NR | NR | Ultrasound monitoring of fetal growth and
AF volume every 4 weeks from 28 to 36 weeks |
|
| Time to delivery | Well-controlled: >39 weeks; insufficient data for others; CD if EFW > 4500 g | NR | NR | Consider induction at 38-39 weeks | Delivery no later than 40 + 6 weeks |
|
