Gestational diabetes mellitus is a condition of impaired glucose tolerance during pregnancy that mostly occurs in the second and third trimesters. Patients are usually asymptomatic but may present with polyhydramnios. The fetus is often large for gestational age. All pregnant women should be screened for gestational diabetes with an oral glucose challenge test. Diagnosis is confirmed with an oral glucose tolerance test (OGTT). Treatment includes glycemic control, e.g., dietary modifications and regular exercise. If glycemic control is insufficient, insulin therapy is initiated. In most cases, gestational diabetes resolves after pregnancy. However, complications may occur, including gestational hypertension, (pre)eclampsia, and development of type 2 diabetes mellitus in the mother and diabetic fetopathy and shoulder dystocia in the fetus.
Pregestational diabetes is type 1 or type 2 diabetes mellitus that is already present prior to pregnancy, and it is associated with a significantly increased risk for maternal and fetal complications during pregnancy and delivery. Management includes stringent glycemic control and close monitoring of fetal development (e.g., regular ultrasounds to screen for congenital abnormalities).
|Features||Gestational diabetes mellitus ||Pregestational diabetes mellitus |
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