Diagnosis and Medical Management of Gestational Diabetes

Sung-Hoon Kim

doi:10.4093/jkd.2015.16.3.174

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Kim: Diagnosis and Medical Management of Gestational Diabetes

Focused Issue

J Korean Diabetes 2015;16(3):174-181.

Published online: 10 January 2015

DOI: https://doi.org/10.4093/jkd.2015.16.3.174

Diagnosis and Medical Management of Gestational Diabetes

Sung-Hoon Kim

Division of Endocrinology & Metabolism, Department of Medicine, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea

Corresponding author: Sung-Hoon Kim Division of Endocrinology & Metabolism, Department of Medicine, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, 17, Seoae-ro 1-gil, Jung-gu, Seoul 04619, Korea, E-mail: hoonie.kim@cgh.co.kr

Received 30 July 2015 Accepted 17 August 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Diagnosis, Gestational diabetes mellitus, Management, Screening

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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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