Glossary

Term · Pregnancy: Your Body

gestational diabetes mellitus

Also: GDM

Another name for gestational diabetes, high blood sugar first found in pregnancy. See gestational diabetes.

In plain words

Gestational diabetes mellitus, or GDM, is the clinical name for the same condition as . It is high blood sugar first detected in pregnancy. The level is not high enough to count as overt diabetes that was there before pregnancy. Clinicians test for it with a glucose challenge or a , and blood sugar is the main measure. Most people with GDM feel well and have no symptoms. The condition matters because it can affect the baby's growth and blood sugar after birth. A diagnosis brings more monitoring and a plan for eating and activity. Blood sugar usually returns to normal after delivery, but the chance of later type 2 diabetes is higher.

The deeper version

Gestational diabetes mellitus is hyperglycemia first detected in pregnancy that does not meet criteria for overt diabetes. Diagnosis rests on glucose testing against fasting and timed thresholds. The one-step IADPSG approach and the two-step approach with both appear in practice, and many US systems still use the latter. The HAPO study (New England Journal of Medicine, 2008) found continuous associations between maternal glucose and neonatal outcomes. The MFMU trial (Landon and colleagues, New England Journal of Medicine, 2009) found that treating mild GDM did not change the primary composite of perinatal outcomes but reduced large-for-gestational-age births, , and . The controversy centers on the thresholds themselves, on universal versus risk-based screening, and on the cost and consequences of diagnosing mild cases.

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Sources

  • Landon MB and colleagues (Maternal-Fetal Medicine Units Network) — A randomized trial of treatment for mild gestational diabetes. New England Journal of Medicine, 2009
  • Carpenter MW and Coustan DR — Criteria for screening tests for gestational diabetes. American Journal of Obstetrics and Gynecology, 1982

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