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Gestational Diabetes Mellitus — Management

Management of glucose intolerance first diagnosed during pregnancy.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

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

What is Gestational Diabetes Mellitus — Management?

Gestational diabetes mellitus (GDM) is glucose intolerance diagnosed in women without a pre-pregnancy diagnosis of diabetes, usually at 24-28 weeks of gestation. It is seen in 6-14% of pregnancies and its prevalence is increasing worldwide.

Increased placental hormones (hPL, estrogen, progesterone, cortisol) during pregnancy lead to physiological insulin resistance. In GDM, pancreatic beta cells are thought to fail to meet this increased insulin demand.

When untreated, the risk of macrosomia, shoulder dystocia, neonatal hypoglycemia, preeclampsia, and polyhydramnios increases. The risk of developing Type 2 DM in later years in women with a history of GDM is 50-70%.

Symptoms

Usually asymptomatic (detected by routine screening)
Polyuria and polydipsia (in severe cases)
Excessive weight gain
Recurrent vaginal candida infections
Macrosomia (fetus larger than expected size on ultrasound)

Risk Factors

Obesity (BMI ≥30)
Previous GDM history
Family history of Type 2 DM (first-degree relative)
Previous macrosomic baby (>4000 g)
Polycystic ovary syndrome
Advanced maternal age (>35)

When to See a Doctor?

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

  • Endocrinology consultation when GDM diagnosis is made on 24-28 week OGTT
  • If glycemic targets are not achieved despite dietary therapy (within 2 weeks)
  • If fasting blood glucose ≥95 mg/dL or postprandial BG ≥140 mg/dL (1 hour)
  • If macrosomia or polyhydramnios is detected in the fetus

Treatment Methods

01
Medical nutrition therapy (carbohydrate-restricted diet, 3 main + 2-3 snacks)
02
Exercise (30 min moderate-intensity walking daily — if no contraindication)
03
Insulin therapy (if targets cannot be achieved with diet — first choice)
04
Postpartum 4-12 week 75 g OGTT (Type 2 DM screening)
05
Lifelong annual DM screening (in women with GDM history)
06
Promotion of breastfeeding (metabolic benefits for mother and baby)

Which Department to Visit?

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

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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.