Gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. GDM generally results in few symptoms; however, it does increase the risk of pre-eclampsia, depression, and requiring a Caesarean section. Babies born to mothers with poorly treated gestational diabetes are at increased risk of being too large, having low blood sugar after birth, and jaundice. If untreated, it can also result in a stillbirth. Long term, children are at higher risk of being overweight and developing type 2 diabetes.

Causes

Gestational diabetes is caused by not enough insulin in the setting of insulin resistance. Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovary syndrome. Diagnosis is by blood tests. For those at normal risk, testing is recommended between 24 and 28 weeks' gestation.

Treatment

Treatment involves diet and exercise. If blood sugar levels are not adequately lowered by these measures, medications such as metformin or insulin may be needed. Whether or not gestational diabetes is a sub-classification of type 2 diabetes is controversial.

Epidemiology

The number of people affected globally is not well known but estimated at 15% of pregnancies. Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy. Doctors most often test for it between 24 and 28 weeks of pregnancy.

See also

• Diabetes mellitus
• Pregnancy
• Insulin
• Metformin

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