Gestational diabetes mellitus

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Gestational diabetes mellitus (GDM)

Defined as glucose intolerance with initial onset or recognition during pregnancy; occurs in up to 5-7% of all pregnancies; hyperglycaemia is associated with increased risk for foetal death and increases risk for foetal macrosomia; a risk assessment should be done for all at the first prenatal visit (increased risk associated with obesity, previous history of GDM, glycosuria, family history).

Increased risk for developing type 2 diabetes after pregnancy (may depend on presence of other risk factors).

Management:
Nutrition advice; daily blood glucose monitoring; weight reduction; insulin (use is associated with decreased foetal morbidity); moderate physical activity; monitoring of blood pressure and urine proteins
Long term monitoring of maternal and offspring glycaemic status

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