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Review
. 2019 Sep;48(3):479-493.
doi: 10.1016/j.ecl.2019.05.001. Epub 2019 Jun 18.

Gestational Diabetes Mellitus

Emily D Szmuilowicz  1 , Jami L Josefson  2 , Boyd E Metzger  3
Affiliations
Review

Gestational Diabetes Mellitus

Emily D Szmuilowicz et al. Endocrinol Metab Clin North Am. 2019 Sep.

Abstract

Although it has been accepted for decades that women with gestational diabetes mellitus (GDM) are at high risk for future development of type 2 diabetes, vigorous debate regarding the value of detecting and treating GDM has persisted into the twenty-first century. Although results from 2 randomized trials provide strong evidence that treating GDM reduces adverse perinatal outcomes, it remains to be determined whether treatment impacts long-term offspring outcomes. Insulin is the first-line pharmacologic treatment and is added when glycemic goals are not met with nutritional modifications. Oral agent use is controversial, as data on long-term offspring outcomes are lacking.

Keywords: Diagnosis; Gestational diabetes mellitus; Offspring; Outcomes; Pregnancy; Treatment.

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Figures

Fig. 1.
Fig. 1.
Frequency of primary outcomes across the glucose categories of fasting, 1-hour, and 2-hour values in a 75-g OGTT. (A) Birth weight >90th percentile. (B) Primary cesarean delivery. (C) Clinical neonatal hypoglycemia. (D) Cord blood serum c-peptide >90th percentile. (From HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008;358(19):1991–2002; with permission.)
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