Optimal management of gestational diabetes

Background: Gestational diabetesmellitus (GDM) is highly prevalent and has both short- and long-term implications for mother and infant. Sources of data: Literature search using PubMed with keywords 'Gestational diabetes' and 'diabetes in pregnancy' together with published papers known to the authors. Areas of agreement: The cornerstone of management is medical nutrition therapy with regular self-monitoring of capillary blood glucose levels and intensification of therapy if glycaemic goals are not achieved. Post-partum, annual assessment for type 2 diabetes is recommended. Areas of controversy: Diagnostic criteria and new biomarkers for GDM and the clinical and economic benefits of treating women with milder levels of glucose intolerance during pregnancy. Growing points: Women with GDM are a heterogeneous group with varying degrees of insulin resistance and beta cell dysfunction. Areas timely for developing research: Development of alternative diagnostic markers and application of novel technologies for GDM management.