Gestational Diabetes Mellitus: Diagnosis and Glycemic Control

Abstract

Gestational diabetes mellitus (GDM) is a major medical complication of pregnancy, and it is related with poor perinatal outcomes and long-term risk of type 2 diabetes. Therefore, adequate diagnosis and treatment are essential to improve pregnancy outcome. Both one-step, 75-g oral glucose tolerance test (OGTT) and two-step, 50- and 100-g OGTTs can be used for diagnosing GDM. The cut-off points of 100-g OGTT are used for the criteria of Carpenter-Coustan. The incidence of GDM can be increased about 2 to 3 times using the one-step method compared to the two-step approach. The mainstay of treatment is composed of life-style management, including exercise and medical nutritional therapy, and insulin therapy. Considering the Korean health-care system, oral hypoglycemic agents cannot be the first-line choice, and intensification of insulin treatment depends on patient self-monitoring of blood glucose. Furthermore, all treatments should be tailored to patient condition. Keywords: Diagnosis; Gestational diabetes mellitus; Glycemic control; Oral glucose tolerance test