Optimal management of gestational diabetes

Abstract

AbstractBackgroundGestational diabetes mellitus (GDM) is highly prevalent and has both short- and long-term implications for mother and infant.Sources of dataLiterature search using PubMed with keywords ‘Gestational diabetes’ and ‘diabetes in pregnancy’ together with published papers known to the authors.Areas of agreementThe cornerstone of management is medical nutrition therapy with regular self-monitoring of capillary blood glucose levels and intensification of therapy if glycaemic goals are not achieved. Post-partum, annual assessment for type 2 diabetes is recommended.Areas of controversyDiagnostic criteria and new biomarkers for GDM and the clinical and economic benefits of treating women with milder levels of glucose intolerance during pregnancy.Growing pointsWomen with GDM are a heterogeneous group with varying degrees of insulin resistance and beta cell dysfunction.Areas timely for developing researchDevelopment of alternative diagnostic markers and application of novel technologies for GDM management.