Review

Gestational diabetes: Its classification and optimal management

Vitoratos Nikolaos, Vrachnis Nikolaos, Vlahos Nikolaos, Peristeris Kostantinos, Iliodromiti Zoe, Creatsas George

2nd Department of Obstetrics and Gynecology, University of Athens, Medical School, Athens, Greece

Correspondence: Vrachnis Nikolaos, 2nd Department of Obstetrics and Gynecology, Aretaieio hospital, University of Athens, Medical School, 124B Vasilissis Sofias Avenue, GR – 11526, Athens, Greece, E – mail: nvrachnis@hjog.org


Abstract

The classification of diabetes mellitus includes diabetes mellitus type I, diabetes mellitus type II, gestational diabetes and other specific types. Unfortunately, the incidence diabetes mellitus in pregnancy, or gestational diabetes, today ranging between 4 and 7%, has been globally on the rise in recent years, particularly among women over 32 years old. According to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG), a pregnant woman can be at low, average or high risk of developing diabetes during pregnancy. A new strategy for the diagnosis of gestational diabetes has been proposed, focusing on the measurement of fasting glucose plasma level to be performed during the 1st trimester of pregnancy. The management of women with gestational diabetes entails: a) treatment of the women, b) antepartum surveillance tests, c) appropriate timing and mode of delivery, d) postpartum follow – up. Management
also includes monitoring after the birth, since the likelihood of developing Diabetes type II is 7 times greater in women with a history of gestational and the recurrence rate of gestational diabetes during a subsequent pregnancy is approximately 40%.

Key words: gestational diabetes, diabetes mellitus, pregnancy, management,  follow – up, classification

p. 67-73