Abstract

Guidelines for the management of gestational diabetes in pregnancy

Author(s): Sarah Glastras and Gregory Fulcher

There is great interest in developing universal guidelines for the diagnosis and treatment of gestational diabetes mellitus (GDM). This stems from the accumulating evidence that GDM is associated with significant risk of adverse outcomes for both mother and neonate. In recent years, the diagnostic thresholds for GDM have been lowered capturing a greater proportion of pregnant women with GDM. The timing and means by which pregnant women should be tested for GDM have not been well studied. Treatment aimed at reducing blood glucose levels appears to be effective in reducing risk of adverse outcomes. The most widely used methods by which to achieve treatment targets are lifestyle modification and insulin. Oral hypoglycemic agents are increasingly being used. There continues to be questions regarding

treatment targets both during pregnancy and parturition. Given the increased risk of Type 2 diabetes in the future, it is important to educate women with GDM

about the ongoing need for periodic testing for diabetes after pregnancy