Diabetes mellitus in pregnancy

Nearly 4% of pregnant women in the United States are diabetic. Of those. 88% have gestational diabetes and 12% have pre-existing diabetes [1]. Because the outcome of pregnancy in diabetic women and the long-terin course of diabetes have improved dramatically over the past few decades, more women who have diabetes are choosing to have babies. Moreover. there has been a significant increase in the prevalence of type 2 and gestational diabetes in the American population, particularly in women of African, Hispanic, and Asian descent [2]. A large proportion of these women are within reproductive age. This article reviews normal and abnormal carbohydrate metabolism in pregnancy, with an emphasis on the challenges that are faced by those who care for the pregnant woman who has hyperglycemia. The growing problem of type 2 diabetes in preognancy the controversial use of oral antihyperglycemic agents for the treatment of gestational diabetes, and the long-term issue of diabetes prevention in those whose hyperglycemia resolves postpartum also are addressed.