Gestational diabetes mellitus (GDM) is defined by glucose intolerance of variable severity with onset of first recognition during pregnancy. Hyperglycaemia during pregnancy is found to be associated with various maternal and perinatal adverse outcomes. Their offsprings will have a life-long increase risk of glucose intolerance, obesity and metabolic syndrome whereas the mothers will have a higher risk of metabolic syndrome and diabetes in the future. The detection of GDM during pregnancy provides an opportunity to identify women at risk of short term and long term complications. We now have evidence that early diagnosis and intervention can reduce the adverse perinatal outcomes. Throughout all these years, there is still no consensus on the optimal diagnostic cut-off until the recent recommendation by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). The purpose of this review is to provide a recent update and discuss the current controversies on GDM. The implications of the recent international consensus statement on new diagnostic criteria for GDM are discussed. Gestational diabetes remains a contentious issue for debate. Screening and subsequent treatment are beneficial for short term outcome and possibly long term outcome. With the generous effort by the IADPSG, a new criterion was proposed and re-instilled the focus to the optimal cut off for GDM diagnosis. It remains uncertain whether the new approach is cost effective or beneficial. The encouraging result and safety profile with OHAs provides a safe alternative to insulin in patient who fails lifestyle modification. While all the research related to management will need to be based on a well-defined criterion of GDM, a consensus is urgently needed. Gestational Diabetes Mellitus Update and Review of Literature, K.W. Cheung and S.F. Wong.
Last date updated on June, 2014