Optimal management of gestational diabetes.

BACKGROUND

Gestational diabetes mellitus (GDM) is highly prevalent and has both short- and long-term implications for mother and infant.

SOURCES OF DATA: Literature search using PubMed with keywords 'Gestational diabetes' and 'diabetes in pregnancy' together with published papers known to the authors.

AREAS OF AGREEMENT: The cornerstone of management is medical nutrition therapy with regular self-monitoring of capillary blood glucose levels and intensification of therapy if glycaemic goals are not achieved. Post-partum, annual assessment for type 2 diabetes is recommended.

AREAS OF CONTROVERSY: Diagnostic criteria and new biomarkers for GDM and the clinical and economic benefits of treating women with milder levels of glucose intolerance during pregnancy.

GROWING POINTS: Women with GDM are a heterogeneous group with varying degrees of insulin resistance and beta cell dysfunction.

AREAS TIMELY FOR DEVELOPING RESEARCH: Development of alternative diagnostic markers and application of novel technologies for GDM management.