Gestational diabetes: screening, diagnosis, treatment and management

Gestational diabetes (GDM) is a common medical condition in pregnancy, and is associated with a range of short and long term maternal and infant complications including pre-eclampsia, pre-term birth, caesarean section, stillbirth, macrosomia and large-for-gestational age, neonatal hypoglycaemia, and increased risk of later type 2 diabetes in both mother and offspring. The incidence of complications can be reduced and pregnancy outcomes for these women are generally good with effective management of hyperglycaemia using regular monitoring of blood glucose, antenatal care with a multidisciplinary team, diet and lifestyle intervention, and pharmacotherapy. Risk of recurrence in future pregnancies, and of later development of type 2 diabetes is high in women with GDM. Attention should be given to screening and reducing risk in women who have experienced GDM, with encouragement of breastfeeding, diet and lifestyle intervention, weight management, and possibly metformin.