Current management of gestational diabetes mellitus

Diabetes mellitus is one of the most common medical complications of pregnancy; gestational diabetes mellitus (GDM) accounts for approximately 90-95% of all cases. GDM is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. It has been demonstrated that good metabolic control maintained throughout pregnancy can reduce maternal and fetal complications in diabetes. Diet is the mainstay of treatment in GDM, but physical activity is a helpful adjunctive therapy when euglycemia is not achieved by diet alone. When diet and exercise fail to maintain euglycemia, exogenous insulin is used and the new insulin currently available on the market may help. Traditionally, insulin therapy has been considered the gold standard for management. The American College of Obstetricians and Gynecologists and the American Diabetes Association do not currently recommend oral hypoglycemic agents as a treatment for GDM. Concerns regarding safety demand further well-designed studies.