Comprehensive Testing Recommendations for Pre-Gestational Diabetes Management by Dr. Donna D. Johnson, MD
Routine prenatal labs, including screening for asymptomatic bacteriuria, hemoglobin A1C, basic tests like BMP and TSH, and frequency of tests such as HbA1C, home glucose monitoring, urine ketones, and serum creatinine are crucial for managing pre-gestational diabetes. Additional assessments like dilated eye exams, EKG for symptoms of hypertension, and vasculopathy should be considered to ensure optimal care. Monitoring proteinuria, blood pressure, thyroid function, and ophthalmology exams are also recommended at various intervals throughout pregnancy to prevent complications in pre-gestational diabetes.
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P:C RATIO OR 24 HOUR URINE WHAT TESTS DO I NEED TO ORDER FOR PRE_GESTATIONAL DIABETES Donna D. Johnson, MD
ROUTINE PRENATAL LABS Asymptomatic bacteriuria 3-5 times more common in DM Can consider culturing every trimester Monitor dip stick each visit
BASIC TESTS BMP TSH Dilated eye exam
P:C RATIO vs. 24 Hour Urine Baseline protein by dipstick 24 hour urine and creatinine clearance PE work up the same No proteinuria P:C ratio PE work up the same
EKG Any symptoms Hypertension Any vasculopathy Retinal or renal
FREQUENCY OF TESTS Test HA1C Home glucose monitoring Urine ketones Urine protein assessment Serum creatinine Frequency Every 4-6 weeks 4 times a day During illness Each visit Baseline and worsening proteinuria or BP Baseline Baseline and follow recommendations Thyroid function Ophthalmology exam
