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Gestational Diabetes Mellitus

Hyperglycemia First Recognized in Pregnancy — Screening and Management

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Gestational Diabetes Mellitus?

Gestational diabetes mellitus (GDM) is hyperglycemia that first develops or is identified during pregnancy, typically after 20 weeks.

Placental hormones (human placental lactogen, cortisol, estrogen) induce insulin resistance that unmasks impaired beta-cell reserve.

Screening is performed at 24–28 weeks using 1-step 75 g OGTT (IADPSG criteria) or 2-step 50 g screen followed by 100 g OGTT.

Untreated GDM increases risks of macrosomia, shoulder dystocia, preeclampsia, neonatal hypoglycemia, and long-term maternal type 2 diabetes.

Symptoms

Usually asymptomatic; detected on screening
Excessive weight gain or polyhydramnios
Fetal macrosomia on obstetric ultrasound
Occasional polyuria, thirst, or recurrent genitourinary infections
Glucosuria on routine prenatal urinalysis
History suggestive of prior large-for-gestational-age infants

Risk Factors

Overweight or obesity prior to pregnancy
Age ≥35 years
Prior GDM, macrosomic infant, or stillbirth
Family history of type 2 diabetes
Polycystic ovary syndrome or significant weight gain in early pregnancy
Ethnic background: South Asian, Middle Eastern, Hispanic, African, Pacific Islander

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Abnormal glucose screening test during pregnancy
  • Fasting glucose >95 mg/dL or 1-h postprandial >140 mg/dL despite diet
  • Polyhydramnios, rapid fetal growth, or signs of preeclampsia

Treatment Methods

01
Medical nutrition therapy with carbohydrate distribution and glycemic index awareness
02
Moderate physical activity (walking after meals) unless contraindicated
03
Self-monitoring of fasting and postprandial glucose targets (<95 and <140 mg/dL at 1 h)
04
Insulin as first-line pharmacotherapy when lifestyle fails; metformin or glyburide per shared decision
05
Increased fetal surveillance (growth ultrasound, NST) in third trimester
06
Postpartum 75 g OGTT at 4–12 weeks and lifelong screening for type 2 diabetes

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.