Gestational diabetes mellitus

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 as close to normal as possible 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 tolerance is performed at least 6 weeks following delivery.

The risk for recurrence of GDM in subsequent pregnancies or progression to type 2 diabetes is high.

Gestational diabetes mellitus (GDM) has traditionally been defined as any degree of glucose intolerance with onset or first recognition during pregnancy. However, the criteria for diagnosis are controversial,[1]Metzger BE, Buchanan TA, Coustan DR, et al. Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care. 2007 Jul;30 Suppl 2:S251-60. http://care.diabetesjournals.org/content/30/Supplement_2/S251.full http://www.ncbi.nlm.nih.gov/pubmed/17596481?tool=bestpractice.com and some authorities now define it as diabetes diagnosed in the second or third trimester of pregnancy that is clearly not overt diabetes.[2]American Diabetes Association. Standards of medical care in diabetes - 2018. Diabetes Care. 2018 Jan 1;41 Suppl 1:S1-159. http://care.diabetesjournals.org/content/41/Supplement_1 It is usually recognised at 24 to 28 weeks of gestation on the basis of abnormal glucose tolerance testing.[2]American Diabetes Association. Standards of medical care in diabetes - 2018. Diabetes Care. 2018 Jan 1;41 Suppl 1:S1-159. http://care.diabetesjournals.org/content/41/Supplement_1