Gestational diabetes

Maternal hyperglycaemia is associated with increased risk of adverse perinatal outcome, in particular, infant birth weight that is large for gestational age, increased infant fat mass, pre-eclampsia and preterm delivery, and an increased need for caesarean section. However, there is controversy regarding the diagnosis and treatment of specific levels of hyperglycaemia during pregnancy. This article summarizes the latest evidence-based recommendations for the diagnosis and classification of gestational diabetes mellitus (GDM). It considers the International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations and epidemiological evidence from the landmark Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) study. It reviews the evidence in support of intensive treatment of hyperglycaemia in pregnancy and provides suggestions for post-partum management to delay and/or prevent progression to type 2 diabetes.