Gestational diabetes

Abstract

Gestational diabetes mellitus (GDM) is the commonest medical condition in pregnancy. It is associated with a range of maternal and infant complications including large-for-gestational-age, stillbirth, pre-term birth, shoulder dystocia, caesarean section, and neonatal hypoglycaemia. Increasingly, longer-term metabolic risks are also being recognized for women who have GDM and their children. Because the relationship between maternal glucose and complications is linear, the appropriate thresholds for diagnosis and treatment remain controversial. Because screening for and treating, GDM can improve outcomes for women and their children, optimizing management warrants widespread attention and implementation. Diet and lifestyle interventions offer sufficient treatment for the majority of women with GDM, however evidence to support specific dietary interventions, and to support either oral hypoglycaemic agents or insulin as the preferred pharmacotherapy is inconsistent. This review provides an up-to-date summary of evidence related to prevention, screening, diagnosis, management, and follow-up of GDM.