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Gestational diabetes mellitus: Glycemic control and maternal prognosis

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

INTRODUCTION

The general approach to treatment of gestational diabetes mellitus (GDM) will be reviewed here. Screening, diagnosis, and obstetrical management are discussed separately. (See "Diabetes mellitus in pregnancy: Screening and diagnosis" and "Pregestational diabetes mellitus: Obstetrical issues and management".)

RATIONALE FOR TREATMENT

Identifying women with GDM is important to minimize maternal and neonatal morbidity. A 2013 systematic review and meta-analysis of randomized trials for the US Preventive Services Task Force found that appropriate management of GDM (nutritional therapy, self blood glucose monitoring, administration of insulin if target blood glucose concentrations are not met with diet alone) resulted in reductions in [1]:

Preeclampsia (relative risk [RR] 0.62, 95% CI 0.43-0.89; 72/1001 [7.2 percent] versus 119/1013 [11.7 percent], three trials)

Birth weight >4000 grams (RR 0.50, 95% CI 0.35-0.71; five trials)

Shoulder dystocia (RR 0.42, 95% CI 0.23-0.77; three trials)  

                              

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Literature review current through: Nov 2016. | This topic last updated: Wed Oct 19 00:00:00 GMT+00:00 2016.
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