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[Management of hyperglycemia in pregnancy (Update 2026)]
Alexandra Kautzky-Willer1, Yvonne Winhofer2, Michael Leutner2
1Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich. alexandra.kautzky-willer@meduniwien.ac.at.
Wiener Klinische Wochenschrift
|May 20, 2026
Summary
New guidelines integrate gestational diabetes mellitus (GDM) and preconception diabetes management for improved maternal and infant health. Key strategies include lifestyle changes, glucose monitoring, and insulin therapy when needed.
Area of Science:
- Endocrinology
- Maternal-Fetal Medicine
- Public Health
Background:
- Hyperglycemia in pregnancy, including gestational diabetes mellitus (GDM) and preconception diabetes, poses significant risks to maternal and fetal well-being.
- Existing guidelines often address diabetes subtypes separately, potentially leading to fragmented care during pregnancy.
Purpose of the Study:
- To present integrated guidelines for managing all forms of hyperglycemia during pregnancy, encompassing both GDM and preconception diabetes.
- To outline updated diagnostic criteria, management strategies, and long-term follow-up recommendations for pregnant women with diabetes.
Main Methods:
- Integration of current evidence and expert consensus on diabetes management in pregnancy.
- Inclusion of recommendations for lifestyle modifications, glucose monitoring, and pharmacotherapy.
- Consideration of preconception care, advanced glucose monitoring technologies, and postpartum follow-up.
Main Results:
- Joint guidelines address lifestyle, glucose monitoring, and pharmacotherapy applicable to all hyperglycemia types in pregnancy.
- Specific diagnostic criteria for early GDM detection are introduced.
- Emphasis on preconception planning, metabolic optimization, and interdisciplinary care for overt diabetes.
Conclusions:
- Integrated management strategies improve outcomes for hyperglycemia in pregnancy.
- Continuous glucose monitoring and automated insulin delivery systems offer advancements in glycemic control.
- Long-term follow-up is crucial for both mothers and children due to elevated risks of type 2 diabetes, cardiovascular disease, obesity, and developmental disorders.
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