Overview
Gestational diabetes mellitus (GDM) is a condition characterized by hyperglycemia that develops during pregnancy 3. It is essential to screen all pregnant women for GDM due to its high prevalence 3.Diagnosis
Screening is recommended between 24 and 28 weeks of gestation 3.
A one-step procedure involves administering a 75g oral glucose load to a fasting pregnant woman and collecting a venous blood sample at 2 hours for plasma glucose estimation 3.
Diagnostic criteria from the American Diabetes Association (ADA) are applicable 3.Management
A team approach involving an obstetrician, diabetes physician, diabetes educator, dietitian, midwife, and pediatrician is ideal 3.
Intensive monitoring, diet, and insulin are the cornerstones of GDM management 3.
Oral agents or analogues are used but remain controversial 3.
Achieving and maintaining normoglycemia is prudent until evidence proves otherwise for ignoring maternal hyperglycemia when fetal growth appears normal 3.
Supervised, low to moderate intensity exercise initiated during the first trimester can decrease the incidence of developing GDM 2.Special Populations
Maternal poor sleep and sleep disturbance during pregnancy negatively impact multiple aspects of childhood health, including metabolism, neurocognition, sleep, and allergy 1.
Short-term intensive care for GDM can lead to long-term benefits in the primary prevention of obesity, impaired glucose tolerance (IGT), and diabetes in offspring 3.Key Recommendations
Screen all pregnant women for GDM, with screening recommended between 24 and 28 weeks of gestation 3. (Evidence: Expert opinion)
Utilize a 75g oral glucose load with a 2-hour plasma glucose measurement for diagnosis 3. (Evidence: Expert opinion)
Implement intensive monitoring, diet, and insulin as the primary management strategy for GDM 3. (Evidence: Expert opinion)
Consider exercise interventions during pregnancy, particularly supervised, low to moderate intensity exercise initiated in the first trimester, to decrease GDM incidence 2. (Evidence: Strong)References
1 Zhang Y, Chen Y, Lu R, Zhao A, Ning Z, Wang D et al.. The impact of maternal sleep during pregnancy on childhood health: A systematic review. Sleep medicine reviews 2025. link
2 Martínez-Vizcaíno V, Sanabria-Martínez G, Fernández-Rodríguez R, Cavero-Redondo I, Pascual-Morena C, Álvarez-Bueno C et al.. Exercise during pregnancy for preventing gestational diabetes mellitus and hypertensive disorders: An umbrella review of randomised controlled trials and an updated meta-analysis. BJOG : an international journal of obstetrics and gynaecology 2023. link
3 Seshiah V, Das AK, Balaji V, Joshi SR, Parikh MN, Gupta S. Gestational diabetes mellitus--guidelines. The Journal of the Association of Physicians of India 2006. link