Hanyang Med Rev.  2017 May;37(1):30-33. 10.7599/hmr.2017.37.1.30.

Management of Gestational Diabetes Mellitus

  • 1Division of Endocrinology and Metabolism, Hanyang University College of Medicine, Seoul, Korea. physicianyu@daum.net


Gestational diabetes mellitus (GDM) is a frequent medical problem during pregnancy. It is associated with an increased risk of complications for GDM mother and the offspring. There is increasing evidence that GDM may increase the risk of future type 2 diabetes and cardiovascular disease in mothers, and may also increase the risk of obesity and diabetes in children. Therefore GDM affects health for a lifetime. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) proposed a new screening approach for pre-diagnosed diabetes at the first prenatal visit and diagnostic criteria for GDM in accordance with perinatal outcomes. Nonetheless, controversies still exist about these issues. There is a positive linear association between increasing maternal glucose at oral glucose tolerance testing and risk of important perinatal outcomes. In managing the GDM patients, an individualized medical approach is essential. If maternal glucose levels have increased, insulin can be used to achieve glycemic targets. Postpartum screening for diagnosing of diabetes is essential for women with previous GDM.


gestational diabetes mellitus; diagnosis; management

MeSH Terms

Cardiovascular Diseases
Diabetes, Gestational*
Glucose Tolerance Test
Mass Screening
Postpartum Period

Cited by  1 articles

Current update in diverse diseases
Seong-Ho Koh
Hanyang Med Rev. 2017;37(1):1-1.    doi: 10.7599/hmr.2017.37.1.1.


1. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997; 20:1183–1197.
2. American Diabetes Association. 2. Classification and Diagnosis of Diabetes. Diabetes Care. 2017; 40:S11–S24.
3. Son KH, Lim NK, Lee JW, Cho MC, Park HY. Comparison of maternal morbidity and medical costs during pregnancy and delivery between patients with gestational diabetes and patients with pre-existing diabetes. Diabet Med. 2015; 32:477–486.
4. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009; 373:1773–1779.
5. Nehring I, Chmitorz A, Reulen H, von Kries R, Ensenauer R. Gestational diabetes predicts the risk of childhood overweight and abdominal circumference independent of maternal obesity. Diabet Med. 2013; 30:1449–1456.
6. O'Sullivan JB, Mahan CM. Criteria for the Oral Glucose Tolerance Test in Pregnancy. Diabetes. 1964; 13:278–285.
7. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982; 144:768–773.
8. HAPO Study Cooperative Research Group. Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358:1991–2002.
9. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. Metzger BE, Gabbe SG, Persson B, Buchanan TA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 33:676–682.
10. Blumer I, Hadar E, Hadden DR, Jovanovic L, Mestman JH, Murad MH, et al. Diabetes and pregnancy: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2013; 98:4227–4249.
11. InDiagnostic Criteria and Classification of Hyperglycaemia First Detected in Pregnancy. Geneva: 2013.
12. National Institutes of Health consensus development conference statement: diagnosing gestational diabetes mellitus, March 4-6, 2013. Obstet Gynecol. 2013; 122:358–369.
13. American Diabetes Association. 2. Classification and Diagnosis of Diabetes. Diabetes Care. 2016; 39:Suppl 1. S13–S22.
14. Moyer VA. U.S. Preventive Services Task Force. Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014; 160:414–420.
15. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005; 352:2477–2486.
16. Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med. 2009; 361:1339–1348.
17. Hartling L, Dryden DM, Guthrie A, Muise M, Vandermeer B, Donovan L. Benefits and harms of treating gestational diabetes mellitus: a systematic review and meta-analysis for the U.S. Preventive Services Task Force and the National Institutes of Health Office of Medical Applications of Research. Ann Intern Med. 2013; 159:123–129.
18. American Diabetes Association. Gestational diabetes mellitus. Diabetes Care. 2003; 26:Suppl 1. S103–S105.
19. de Veciana M, Major CA, Morgan MA, Asrat T, Toohey JS, Lien JM, et al. Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. N Engl J Med. 1995; 333:1237–1241.
20. Kjos SL, Schaefer-Graf U, Sardesi S, Peters RK, Buley A, Xiang AH, et al. A randomized controlled trial using glycemic plus fetal ultrasound parameters versus glycemic parameters to determine insulin therapy in gestational diabetes with fasting hyperglycemia. Diabetes Care. 2001; 24:1904–1910.
21. Gui J, Liu Q, Feng L. Metformin vs insulin in the management of gestational diabetes: a meta-analysis. PLoS One. 2013; 8:e64585.
22. Rowan JA, Hague WM, Gao W, Battin MR, Moore MP. MiG Trial Investigators. Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med. 2008; 358:2003–2015.
23. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014; 37:Suppl 1. S14–S80.
24. Committee on Practice Bulletins--Obstetrics. Practice Bulletin No. 137: Gestational diabetes mellitus. Obstet Gynecol. 2013; 122:406–416.
25. Ratner RE, Christophi CA, Metzger BE, Dabelea D, Bennett PH, Pi-Sunyer X, et al. Prevention of diabetes in women with a history of gestational diabetes: effects of metformin and lifestyle interventions. J Clin Endocrinol Metab. 2008; 93:4774–4779.
Full Text Links
  • HMR
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr