The epidemic of medical child abuse - and what can be done about it

(NaturalNews) The primary purpose of this article is to encourage a stronger commitment from doctors and parents to consider using safer medical care for infants and children FIRST before resorting to more dangerous treatments. One would hope and assume that doctors and parents would have a natural inclination to make the safety of these young human souls a significant and sincere priority, but sadly, the power and propaganda of Big Pharma has inappropriately turned this equation around and made it seem that doctors and parents are putting their children at risk if they don't prescribe powerful drugs first. This writer personally disagrees with this assumption and sincerely hopes thatpeopleconsider this health issue to be of primary importance today.

Theevidencepresented below on the epidemic proportions of "medicalchild abuse" is somewhat inflammatory, but due to the fact that this issue is presently being ignored by so many doctors and

parents, a little "inflammation" may be a necessary symptom that will lead to great attention to this problem and perhaps to some concrete solutions to it.

Although many people consider American health care to be "the best in the world," the World Health Organization has ranked the United States to be the 37th (!) in the world in the "performance of the overall health system" and 72nd (!!) in "overall level of health" (of the 191 member countries). American health care may be the most expensive, but there is no evidence to prove that increased expense leads to improved health status.When one looks at the countries where health status and overall health scores the highest, they are countries in which there are a significant number of physicians and other health care practitioners who use herbal medicines, homeopathic remedies, acupuncture and nutritional treatments. Perhaps American doctors and patients would benefit from a significant change in health care practices that are not only considerably safer than modern medical treatments, but that also seem to create better health care status.A newly published review of the six leading medical journals uncovered a truly shocking observation: No information on severe adverse events and withdrawal of patients owing to an adverse event was given in 27.1% and 47.4% of articles, respectively.[1] When one considers that this review only analyzed the medical journals, we can and should seriously worry about the safety of many drugs that are used today, and we should express real indignation when doctors prescribe two or more together (unless they were formally tested together) or when doctors prescribe them for conditions for which they have not been tested (called "off-label").Ultimately, although physicians assume that they are practicing "scientific medicine ," most drugs today are not tested on infants or children, and most children and adults are prescribed more than one drug at a time (and drugs are very rarely tested for efficacy or safety when used in combination with other drugs). These common practices lead one to assume that modern medicine is not adequately scientific, and these practices may be part of the explanation for the poor health status of Americans.The Very Real Problem...We all know people who have children who have benefited from conventional medical care, but sadly, we all also know people whose children have been harmed by it. The most famous words of the father of medicine, Hippocrates, are "First, do no harm." This dictum was directed at doctors, but it is as appropriate for parents. Sadly, however, our children are being put in front of harm's way with our present, almost callous overuse of powerful drugs for our young ones.The bottom line is that too many physicians and parents are giving drugs to children that have not been proven to be either safe or effective for them. It is important for parents to know and to remind doctors that it is widely acknowledged that drugs act differently on the bodies of infants and children than on adults. And yet, it is extremely common for doctors to prescribe powerful drugs to infants and children and even prescribe more than one drug at a time, despite the fact that drugs are very rarely evaluated scientifically in combination with other drugs.The FDA recently withdrew from the marketplace many popular cold and cough drugs that were marketed for infants and children,[2] but the problem of doctors over-prescribing other more dangerous and unproven drugs for children and the inappropriate overuse of over-the-counter drugs in children by parents is a very significant health problem. One must wonder if the increase in psychiatric disorders, immune dysfunction, autism and various other chronic diseases result from the use of the drugs that have not yet been proven to be either safe or effective for our infants and children.Most consumers do not know that many drugs commonly prescribed for children today are not tested on them.[3] A 2002 survey in the British Medical Journal (BMJ) found that almost one-half of children were prescribed a drug that was "unlicensed" or "off-label" prescriptions for children.[4] A 2007 study of over 350,000 children found that a shocking 78.7% of children in hospitals are prescribed drugs that the FDA has not approved for use in children.[5] If this isn't shocking enough, it is seriously problematic to report that a survey in England found that 90% of infants were prescribed drugs that were not tested for safety or efficacy in infants.If the off-label use for drugs was not found to be dangerous, it would not be a problem. However, the use of off-label drug use is significantly associated with adverse drug reactions . In fact, there is almost a 350% increase in adverse drug reactions in children prescribed an off-label drug than children who were prescribed a drug that had been tested for safety and efficacy.[7] The use of drugs for infants and children that have not been proven to be safe constitutes a type of "medical child abuse."Despite some significant gaps in research and knowledge about the safety and efficacy of drugs for children, the number of drugs prescribed for children has jumped significantly in recent years. In the U.S., the number of prescription drugs for children with asthma increased 46.5% from 2002 to 2005. In this same time, the number of prescription drugs for children with ADD/ADHD increased 40.5%, and even the number of prescription drugs for lowering cholesterol in children increased by 15%.[8]In 2007, the Journal of the American Medical Association (JAMA) reported significant increases in childhood chronic diseases.[9] Since 1960, there has been a 280% (!) increase in the limitation of activity due to a health condition of more than 3 months duration. This article also noted a shadow side of increased vaccination usually ignored by physicians and the media: decreased exposure to viral infections in early childhood...may provide less and less normal stimulation of the immune system with more susceptibility to allergies in later years.What can be done and what is being done...First and foremost, physicians have to STOP prescribing as many drugs as they are prescribing, and must significantly reduce the number of off-label prescribing of drugs for infants and children. I am not suggesting that they stop the use of all off-label prescribing, but that they work to significantly reduce these more risky prescriptions.Because they sometimes feel pressure from patients who want drugs (or something) to help their infant or child, doctors need to warn parents that many drugs have not yet been adequately tested for safety and efficacy for children. Doctors need to become better educators so that parents can better decide which risks they wish to take either with conventional drugs or various safer alternatives.Doctors also need to begin learning about safer treatment methods. Although some alternative methods may not yet be adequately tested for efficacy (usually because Big Pharma cannot make as much money making and selling these treatments), natural therapies certainly have a much better safety profile, and there is a body of experience historically and internationally to suggest that many (not all) natural treatments can aid in the healing of many pediatric ailments. In honor of the Hippocratic dictum, "first, do no harm," doctors need to explore and even exhaust safer methods before resorting to the highly risky treatment modalities.Because the FDA recently withdrew from the marketplace many popular cold and cough medicines, more parents and physicians should explore safer homeopathic and botanical alternatives. One of the books that I co-authored with Stephen Cummings, MD,Everybody's Guide to Homeopathic Medicines, has been the most popular guidebook to using homeopathic medicine. Besides explaining how to choose a homeopathic medicine that fits the sick person's unique syndrome of symptoms, this book is also widely appreciated because it provides detailed guidelines that define when it is medically safe to use a safer alternative treatment or when medical supervision is recommended.Another useful, though more technical resource was recently published by Oxford University Press (OUP), one of the most highly respected publishers of medical textbooks and medical journals. OUP has begun to publish a series of textbooks on "integrative medicine," which is the emerging field of utilizing the best of the various natural treatment modalities and the best of conventional medicine.; OUP also recently publishedIntegrative Pediatrics(edited by two pediatricians, Timothy Culbert, MD, and Karen Olness, MD).Nowadays, virtually every leading conventional medical school in America has a course in "integrative medicine"; (or alternative and complementary medicine).[10] Although these courses are generally just an overview and introduction to the various alternative therapies , they provide good seeds for the medical students to determine which treatments should be a part of the medical care they will later provide. One way to predict the future of medicine is to ask medical students what interests them.In 2008, the American Academy of Pediatrics (AAP) published a position paper acknowledging the widespread use of alternative and complementary therapies for children and encouraging doctors to discuss options with parents.[11] An AAP survey found that 54% of pediatricians in the US agreed that pediatricians should consider the use of all potential therapies, not just those of mainstream medicine.Doctors, however, need to understand that alternative therapies are not just a different treatment, but also a different approach to understanding and treating whole person health care. Acupuncture, ayurveda, and homeopathic medicines provide time-tested and historically verified benefits that deserve the investigation of doctors and parents everywhere who want to use safer methods before resorting to more risky treatments. And there is a small but significant (and growing) body of research to confirm the efficacy of these systems of medicine, despite the strong tendency for skeptics to ignore this body of evidence.Parents have to START asking their doctors if the drugs they are prescribing for their children have formally been found to be safe for them. If more than one drug is recommended, parents should ask for the evidence that these two drugs, taken together, are safe and effective. Parents will benefit from learning when some type of medical treatment is truly necessary because many common ailments do not require medical attention, therefore safer home treatment methods can and should be considered.The bottom line is that there is increasing interest in alternative and complementary treatments for children. A survey in Canada published inPediatrics(2007) found that more than half of the children who visited a university-affiliated hospital had received alternative and complementary medicines.[12] Homeopathic medicine was by far the most popular treatment, used by 39% of the families.In 2002, theBritish Medical Journalreported that 75% of Germans have used complementary or natural medicine.[13] They also reported that 5,700 doctors received specialized training in natural medicine, with this number doubling to 10,800 by 2000. Homeopathic medicine is practiced by 4,500 medical doctors in Germany, almost twice as many as did so in 1994. The German government conducted this survey, discovering a 33% reduction in sick days if people used natural therapies, especially homeopathy or acupuncture.Although homeopathic medicine is not well known in the U.S., homeopathy has maintained a unique international presence that has included appreciation and advocacy for many of the most respected cultural heroes of the past 200 years, including 11 U.S. Presidents and scores of world leaders (ranging from Gandhi to Tony Blair), six popes, numerous European royalty, literary greats, sports superstars, corporate leaders, as well as a wide range of first class physicians and scientists.[14]In reference to homeopathy, it is common for skeptics of homeopathy to purposefully misinform others that there is no research that proves that homeopathy works. Such misinformation is typical of Big Pharma shills and closed-minded skeptics who revel in confusing the public.In fact, one of the most serious public health problems in the developing world today is diarrhea, a condition that claims the lives of several million kids each year as a result of dehydration. Three double-blind and placebo-controlled trials have shown efficacy of treatment from homeopathic care.[15] The number one reason that children in the U.S. seek medical treatment is for ear infections, and the American Academy of Pediatrics has sought to discourage doctors from prescribing antibiotics due to their questionable efficacy and potential problems. There is some good evidence that homeopathic medicines are effective for this common ailment

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HHS releases new plan to prevent and treat viral hepatitis

(NaturalNews) Viral hepatitis remains a public health challenge in the United States. Approximately 3.5-5.3 million persons are living with the condition, and millions more are at risk for infection. Hepatitis, which is largely preventable, is the leading cause of liver cancer. Without appropriate care, 1 in 4 persons with chronic hepatitis will develop liver cirrhosis or liver cancer.

In January 2010, the Institute of Medicine (IOM) released a report on hepatitis, explaining the barriers to hepatitis prevention and treatment. In response to this, The U.S. Department of Health and Human Services (HHS) just released the Viral Hepatitis Action Plan --Combating the Silent Epidemic: US Department of Health and Human Services Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. The Plan is meant to result in:

- more people being aware that they have the condition

- a reduction in new cases(NaturalNews) Viral hepatitis remains a public health challenge in the United States. Approximately 3.5-5.3 million persons are living with the condition, and millions more are at risk for infection. Hepatitis, which is largely preventable, is the leading cause of liver cancer. Without appropriate care, 1 in 4 persons with chronic hepatitis will develop liver cirrhosis or liver cancer.

In January 2010, the Institute of Medicine (IOM) released a report on hepatitis, explaining the barriers to hepatitis prevention and treatment. In response to this, The U.S. Department of Health and Human Services (HHS) just released the Viral Hepatitis Action Plan --Combating the Silent Epidemic: US Department of Health and Human Services Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. The Plan is meant to result in:

- more people being aware that they have the condition

- a reduction in new cases


a complete elimination of mother to child transmission of Hepatitis B

Although viral hepatitis is a leading cause of infectious death in the U.S., many people are unaware they have the condition because often time they don't feel the symptoms, or the symptoms are there, but just feel like the flu.

Here's a quick overview of viral hepatitis:

Hepatitis A - found in the feces of infected persons. Hepatitis A spreads from one person to another by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This can happen when people do not wash their hands after using the toilet and then touch other people's food. Typically, milder symptoms than hepatitis Bor C. Illness from hepatitis A is usually brief, and infection with the virus does not lead to chronic liver disease or liver cancer.

Hepatitis B - found in blood and certain body fluids of infected persons. Hepatitis B spreads when a person who is not immune comes in contact with blood or body fluid from an infected person. Hepatitis B is spread by having sex with an infected person without a condom, sharing needles during injected drug use, needle sticks or sharps, exposures in a health care setting, or from an infected mother to her baby during vaginal birth. Exposure to blood in any situation can be a risk for transmission. There are usually no symptoms until there are serious liver complications. When symptoms do appear, they may include high fever, jaundice and abdominal pain chronic hepatitis B can lead to cirrhosis and/or liver cancer.

Hepatitis C - also found in blood and certain body fluids of infected persons. Hepatitis C spreads when a person who is not immune comes in contact with blood or body fluids from an infected person. Hepatitis C is spread through sharing needles during injecteddruguse, needle sticks or sharps, exposures in ahealthcare setting, through organ transplants that have not been screened, or less commonly from an infected mother to her baby during vaginal birth. It is possible to gethepatitis Cfrom sex, but it is uncommon. Infection with the hepatitis Cvirusis the number one reason for liver transplant in the U.S. Unlike hepatitis A and B, there is no vaccine to prevent hepatitis C.

There is a simple blood test to check for the Hepatitis virus.

Hopefully, with the guidance of this plan and the collaboration of policy figures, stake holders, and health care practitioners we can reduce the transmission of this silentepidemic.

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Natural source of omega-3 Fish Oil 1000mg

Each softgel capsule contains
Fish oil - natural (1000 mg) 1g

400 Capsules

AUST L 121387
Healthy Care regularly tests their Fish oil for mercury
Fish oil is extracted from cold water fish and is a natural source of marine omega-3 fatty acids. Fish Oil contains the omega-3 fatty acids EPA and DHA, and can be taken as a dietary supplement.
Fish oil provides an anti-inflammatory action within the body which may reduce inflammation and joint swelling associated with arthritis. Omega-3 fatty acids are also important for cardiovascular health.
In addition to these benefits, Healthy Care Fish Oil 1000 is a beneficial supplement to take if you can't manage the recommended 2-3 serves of fish a week. It is also high in DHA which is necessary for the normal function of the eye, brain and nervous system.
To ensure you can take Healthy Care Fish Oil 1000 with confidence, Healthy Care regularly tests its fish oil for mercury and only uses high quality fish oil without added artificial surfactants to disguise fishy odors.

Benefits:

Helps relieve symptoms of :
-- Arthritis
-- Swollen Joints
-- Dermatitis
-- Psoriasis
-- Inflammatory Disorders

Maintains normal healthy :
-- Cardiovascular system
-- Eye Function
-- Brain function
-- Cholesterol level
-- Nervous System

Active Ingredient:

Fish Oil-Natural (Salmon Oil)	750mg
Natural Vitamin E - 10 IU (Equiv. d-alpha-Tocopherol 6.71mg)
Natural Fish Oil 1000mg contains:
Omega-3 Marine Triglycerides 300mg as:
Eicosapentaenoic Acid (EPA)	180mg
Docosahexaenoic Acid (DHA)	120mg
(Equiv. Vitamin A 25 IU)
[Equiv. Vitamin D3 2.5 IU (Cholecalciferol 62.5mg)]

No added sugar, yeast, gluten, starch, wheat, corn, milk derivatives, preservatives, artificial colours, flavours and sweeteners. Always read the label. Use only as directed. If symptoms persist see your doctor or healthcare professional.

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Diabetes Medical Treatment

Diabetes Medical Treatment

The treatment of diabetes is highly individualized, depending on the type of diabetes, whether the patient has other active medical problems, whether the patient has complications of diabetes, and age and general health of the patient at time of diagnosis.

• A health care professional will set goals for lifestyle changes, blood sugar control, and treatment.
• Together, the patient and the health care professional will formulate a plan to help meet those goals.

Education about diabetes and its treatment is essential in all types of diabetes.

• When the patient is first diagnosed with diabetes, the diabetes care team will spend a lot of time with the patient, teaching them about their condition, treatment, and everything they need to know to care for themselves on a daily basis.
• The diabetes care team includes the health care professional and his or her staff. It may include specialists in foot care, neurology, kidney diseases, and eye diseases. A professional dietitian and a diabetes educator also may be part of the team.

The health care team will see the patient at appropriate intervals to monitor their progress and evaluate goals.

Type 1 diabetes

Treatment of diabetes almost always involves the daily injection of insulin, usually a combination of short-acting insulin (for example, lispro [Humalog] or aspart [NovoLog]) and a longer acting insulin (for example, NPH, Lente, glargine [Lantus], detemir [Levemir]).

• Insulin must be given as an injection just under the skin. If taken by mouth, insulin would be destroyed in the stomach before it could get into the blood where it is needed.
• Most people with type 1 diabetes give these injections to themselves. Even if someone else usually gives the patient injections, it is important that the patient knows how to do it in case the other person is unavailable.
• A trained professional will show the patient how to store and inject the insulin. Usually this is a nurse who works with the health care professional or a diabetes educator.
• Insulin is usually given in two or three injections per day, generally around mealtimes. Dosage is individualized and is tailored to the patient's specific needs by the health care professional. Longer acting insulins are typically administered one or two times per day.
• Some people have their insulin administered by continuous infusion pumps to provide adequate blood glucose control. Supplemental mealtime insulin is programmed into the pump by the individual as recommended by his or her health care professionals.
• It is very important to eat after the taking insulin, as the insulin will lower blood sugar regardless of whether the person has eaten. If insulin is taken without eating, the result may be hypoglycemia. This is called an insulin reaction.
• There is an adjustment period while the patient learns how insulin affects them, and how to time meals and exercise with insulin injections to keep blood sugar levels as even as possible.
• Keeping accurate records of blood sugar levels and insulin dosages is crucial for the patient's diabetes management.
• Eating a consistent, healthy diet appropriate for the patient's size and weight is essential in controlling blood sugar level.

Type 2 diabetes

Depending on how elevated the patient's blood sugar and glycosylated hemoglobin (HbA1c) are at the time of diagnosis, they may be given a chance to lower blood sugar levels through lifestyle changes, without medication.

• The best way to do this is to lose weight if the patient is obese, and begin an exercise program.
• This will generally be tried for 3 to 6 months, then blood sugar and glycosylated hemoglobin will be rechecked. If they remain high, the patient will be started on an oral medication, usually a sulfonylurea or biguanide (metformin [Glucophage]), to help control blood sugar levels.
• Even if the patient is on medication, it is still important to eat a healthy diet, lose weight if they are overweight, and engage in moderate physical activity as often as possible.
• The health care professional will initially monitor the patient's progress on medication very carefully. It is important to receive just the right dose of the right medication, to regulate blood sugar levels in the recommended range with the fewest side effects.
• The doctor may decide to combine two types of medications to achieve blood sugar levels control.
• Gradually, even people with type 2 diabetes may require insulin injections to control their blood sugar levels.
• It is becoming more common for people with type 2 diabetes to take a combination of oral medication and insulin injections to control blood sugar levels.

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Standards of Medical Care for Diabetes

Standards of Medical Care for Patients With Diabetes Mellitus

1. American Diabetes Association

Diabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes.

These standards of care are intended to provide clinicians, patients, researchers, payers, and other interested persons with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Skyler (Ed.): Medical Management of Type 1 Diabetes (1) and Zimmerman (Ed.): Medical Management of Type 2 Diabetes (2).

The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the Association and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations

CLASSIFICATION, DIAGNOSIS, AND SCREENING

Classification

In 1997, the American Diabetes Association issued new diagnostic and classification criteria (3).

The classification of diabetes mellitus includes four clinical classes

1. Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
2. Type 2 diabetes (Results from a progressive insulin secretory defect on the background of insulin resistance)
3. Other specific types of diabetes (due to other causes, e.g., genetic defects in β-cell function, genetic defects in insulin action, diseases of the exocrine pancreas, drug or chemical induced)
4. Gestational diabetes mellitus (GDM) (diagnosed during pregnancy)

Diagnosis

Criteria for the diagnosis of diabetes in nonpregnant adults are shown in Table 2. Three ways to diagnosis diabetes are available and each must be confirmed on a subsequent day. Because of ease of use, acceptability to patients and lower cost, the fasting plasma glucose (FPG) is the preferred test.

Hyperglycemia not sufficient to meet the diagnostic criteria for diabetes is categorized as either impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on whether it is identified through a FPG or an oral glucose tolerance test (OGTT):   IFG = FPG ≥110 mg/dl (6.1 mmol/l) and  <126 mg/dl (7.0 mmol/l)  Or FPG 110 mg/dl (6.1 mmol/l)  to 125 mg/dl (6.9 mmol/l) IGT = 2-h PG ≥140 mg/dl (7.8 mmol/l)  and <200 mg/dl (11.1 mmol/l)  Or 2-h PG 140 mg/dl (7.8 mmol/l) to  199 mg/dl (11.0 mmol/l)  

Both categories, IFG and IGT, are risk factors for future diabetes and cardiovascular disease. Recent studies have shown that lifestyle interventions can reduce the rate of progression to type 2 diabetes (5,6,7).

Screening

Generally, people with type 1 diabetes present with acute symptoms of diabetes and markedly elevated blood glucose levels. Type 2 diabetes is frequently not diagnosed until complications appear, and approximately one-third of all people with diabetes may be undiagnosed. Although the burden of diabetes is well known, the natural history is well characterized, and there is good evidence for benefit from treating cases diagnosed through usual clinical care, there are no randomized trials demonstrating the benefits of early diagnosis through screening of asymptomatic individuals (8). Nevertheless, there is sufficient indirect evidence to justify opportunistic screening in a clinical setting of individuals at high risk. Criteria for testing for diabetes in asymptomatic, undiagnosed adults are listed in Table 3. The recommended screening test for nonpregnant adults is the FPG.

The incidence of type 2 diabetes in children and adolescents has been shown to be increasing. Consistent with screening recommendations for adults, only children and youth at increased risk for the presence or the development of type 2 diabetes should be tested (9). See Table 4.

Detection and diagnosis of GDM

Risk assessment for GDM should be undertaken at the first prenatal visit. Women with clinical characteristics consistent with a high risk for GDM (those with marked obesity, personal history of GDM, glycosuria, or a strong family history of diabetes) should undergo glucose testing as soon as possible (10). A fasting plasma glucose ≥126 mg/dl or a casual plasma glucose ≥200 mg/dl meets the threshold for the diagnosis of diabetes, if confirmed on a subsequent day. High-risk women not found to have GDM at the initial screening and average-risk women should be tested between 24 and 28 weeks of gestation. Testing should follow one of two approaches:

1. One-step approach: perform a diagnostic OGTT.
2. Two-step approach: perform an initial screening by measuring the plasma or serum glucose concentration 1 h after a 50-g oral glucose load (glucose challenge test [GCT]) and perform a diagnostic OGTT on that subset of women exceeding the glucose threshold value on the GCT. When the two-step approach is employed, a glucose threshold value ≥140 mg/dl identifies ∼80% of women with GDM, and the yield is further increased to 90% by using a cutoff of ≥130 mg/dl.

Diagnostic criteria for the 100-g OGTT is as follows: ≥95 mg/dl fasting; ≥180 mg/dl at 1 h; ≥155 mg/dl at 2 h; ≥140 mg/dl at 3 h. Two or more of the plasma glucose values must be met or exceeded for a positive diagnosis. The test should be done in the morning after an overnight fast of 8–14 h. The diagnosis can be made using a 75-g glucose load, but that test is not as well validated for detection of at-risk infants or mothers as the 100-g OGTT.

Low risk status requires no glucose testing, but this category is limited to those women meeting all of the following characteristics:

1. Age <25 years
2. Weight normal before pregnancy
3. Member of an ethnic group with a low prevalence of GDM
4. No known diabetes in first-degree relatives
5. No history of abnormal glucose tolerance
6. No history of poor obstetric outcome

Recommendations

 

A-Level evidence

1. In those with IFG/IGT, lifestyle modification should be considered.

Expert consensus

1. The FPG is the preferred test to screen for and diagnose diabetes.
2. Screen for diabetes in high-risk, asymptomatic, undiagnosed adults and children within the health care setting.
3. Screen for diabetes in pregnancy using risk factor analysis and screening tests as noted.
   
   

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