Journal List > J Korean Diabetes > v.16(3) > 1054971

Kim: Diagnosis and Medical Management of Gestational Diabetes

Abstract

Gestational diabetes mellitus (GDM) is one of the most common medical complications during pregnancy. Both mother and baby are at increased risk of adverse pregnancy outcomes, as well as long-term metabolic effects such as diabetes. Diagnosing and treating GDM can reduce perinatal complications. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has proposed a new screening strategy for overt diabetes at the first prenatal visit and diagnostic criteria for GDM based on perinatal outcomes. However, controversies still exist and there is no international consensus about these issues. Regarding the management of GDM, individualized medical nutrition therapy is the cornerstone of treatment. If maternal glucose levels and/or fetal growth patterns show a sufficiently high risk of perinatal complications, insulin can be used to intensify treatment, and regimens should be tailored to meet glycemic targets. Postpartum screening for early detection of glucose intolerance and implementation of diabetes prevention programs are important for women with a history of GDM.

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Table 1.
Diagnostic criteria for gestational diabetes mellitus
  NDDG 100 g OGTT Carpenter-Coustan IADPSG 75 g OGTT
Fasting (mg/dL) 105 95 92
1 h (mg/dL) 190 180 180
2 h (mg/dL) 165 155 153
3 h (mg/dL) 145 140  

OGTT, oral glucose tolerance test; IADPSG, The International Association of Diabetes and Pregnancy Study Groups; NDDG, National Diabetes Data Group.

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