Gestational diabetes mellitus diagnosis and treatment goals: measurement and measures

Gestational diabetes mellitus (GDM) is defined as diabetes diagnosed during pregnancy that is not clearly overt diabetes. It is the most common complication of pregnancy and is the most common type of diabetes during pregnancy. Its high prevalence is determined by the increasing epidemic of obesity and by the diagnostic criteria applied. New criteria are currently accepted by a number of professional societies, but considerable controversies still exist concerning diagnosis of GDM. GDM can cause significant short term and long term problems for mother and offspring, including but not limited to cesarean delivery, birth trauma, as well as the development of type 2 diabetes in mother and offspring in the future. Although the consequences of poorly controlled GDM are evident, there continues to be controversy regarding the most appropriate diagnostic criteria, the metabolic aims in controlling GDM, the ability to diagnose GDM in early pregnancy, and the efficiency of treatment in order to improve pregnancy outcomes. This review focuses on current recommendations of professional medical societies and evidence base for GDM diagnosis and glycemic goals of treatment. Available evidence for the optimal time and frequency of self-monitoring of blood glucose and the role of glycated haemoglobin in GDM is also provided in this review.