DOI: 10.36347/sasjm

Pages: 93-99

Gestational Diabetes Mellitus (GDM) is a controversial entity, with conflicting guidelines and treatment protocols. There are various types of diagnostic methods of GDM; each country has got their own. However, 75-gm 2- hour oral glucose tolerance test is widely practiced. Recent studies show that diagnosis and management of this disorder have got additional beneficial effects on the mother and the fetus including reduced rates of preeclampsia, shoulder dystocia, birth trauma, and neonatal hypoglycemia. There is also less incidence of development of obesity and metabolic syndrome in later life of the mother and child. Treatment consists of glucose monitoring, dietary modification, exercise, and when necessary pharmacotherapy to maintain euglycemia. Insulin therapy is the mainstay of treatment, though glyburide and metformin are also used in selected cases. Use of insulin analogue including basal-bolus therapy is a recent addition in the management. Fructosamine as a measure of glycemic control is not widely used due to lack of standardization. In women receiving pharmacotherapy, antenatal testing with non-stress tests and amniotic fluid indices are started in the third trimester to monitor fetal well-being. The method and timing of delivery are controversial. Following delivery follow up is needed. Women with gestational diabetes are at high risk of subsequent development of type 2 diabetes. Lifestyle modification should therefore be encouraged, along with regular screening for diabetes