Screening, complications and treatment of gestational diabetes

Gestational diabetes (GD) is a condition of increasing incidence, largely as a result of a higher prevalence of maternal obesity. Women diagnosed with GD have a greater risk of adverse pregnancy and perinatal outcome and are also more likely to be diagnosed with type 2 diabetes in later life. Recent updated criteria for the diagnosis of gestational diabetes recommend its diagnosis at more modest degrees of hyperglycaemia during pregnancy. However, there is no consensus on how best to screen or diagnose this condition. Recent evidence suggests that treatment with metformin may be a safe alternative or adjunct to insulin. Additionally, active management of lower degrees of maternal hyperglycaemia improves gestational outcome. This article looks at screening guidelines, complications and treatment of GD.