Abstract
Gestational diabetes mellitus (GDM) is carbohydrate intolerance that is first recognized in pregnancy. GDM is associated with both short- and long-term adverse outcomes for mothers and their offspring. The prevalence of GDM is rising, associated with changing environmental factors (e.g., increasing obesity, sedentary lifestyle, Western diet) and altered diagnostic criteria, and it continues to be associated with adverse pregnancy outcomes. Treatment of GDM includes intensive lifestyle management, followed by pharmacological intervention with insulin or selective oral antihyperglycemic agents if glycemic targets are not met. The prevalence of Type 2 diabetes mellitus (T2DM) in pregnancy has also increased significantly in the past four decades, surpassing Type 1 diabetes (T1DM) in many countries. Despite advances in management, including insulin delivery systems and glucose monitoring, T2DM continues to result in a number of maternal and perinatal complications, resulting in poorer outcomes than women with T1DM. Exacerbating factors include less frequent uptake of preconception counseling and coexisting obesity. In this chapter, we review the changing epidemiology of GDM and T2DM in pregnancy, screening practices, and management.
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