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Diabetes mellitus in pregnancy: Screening and diagnosis

Donald R Coustan, MD
Section Editors
David M Nathan, MD
Michael F Greene, MD
Deputy Editor
Vanessa A Barss, MD, FACOG


Pregnancy is accompanied by insulin resistance, mediated primarily by placental secretion of diabetogenic hormones including growth hormone, corticotropin-releasing hormone, placental lactogen, and progesterone. These and other metabolic changes ensure that the fetus has an ample supply of nutrients. (See "Maternal adaptations to pregnancy: Endocrine and metabolic changes".)

Gestational diabetes develops during pregnancy in women whose pancreatic function is insufficient to overcome the insulin resistance associated with the pregnant state. Among the main consequences are increased risks of preeclampsia, macrosomia, and cesarean delivery, and their associated morbidities.

The approach to screening for and diagnosis of diabetes in pregnant women will be reviewed here. Management and prognosis are discussed separately:

(See "Gestational diabetes mellitus: Glycemic control and maternal prognosis".)

(See "Gestational diabetes mellitus: Obstetrical issues and management".)

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Literature review current through: Sep 2017. | This topic last updated: Sep 13, 2017.
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