Summary

• Develops during pregnancy and is usually diagnosed at 24 to 28 weeks of gestation on the basis of elevated plasma glucose levels on glucose tolerance testing.
• Goal of therapy is to achieve maternal glucose levels that are high normal or lower in order to avoid fetal macrosomia and complications.
• Initial therapy for gestational diabetes is usually dietary modification. Insulin is started when acceptable glucose levels cannot be maintained with diet alone.
• Maternal postnatal testing for diabetes or impaired glucose metabolism is performed at least 6 weeks following delivery.
• The long-term risk for recurrence or type 2 diabetes is high.