A Review on the Management of Gestational Diabetes Mellitus (GDM): Pharmacological and Non-Pharmacological Interventions
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Keywords

Gestational diabetes mellitus
Postprandial glucose
Macrosomia
OHA
Neonatal
Pre-eclampsia

DOI

10.26689/jcnr.v6i4.4164

Abstract

Gestational diabetes mellitus (GDM) is defined as any degree of glucose or carbohydrate intolerance mainly during pregnancy. About 10% to 15% of pregnancies are affected and complicated by gestational diabetes. Due to hormonal changes during pregnancy, the requirement for insulin increases, and thus the usual concentration of insulin previously catered for glycemic control is ineffective. In order to meet the body’s demand, the islet cells secrete a higher amount of insulin. GDM occurs when this higher concentration is also unable to control blood glucose. This increased resistance toward insulin is most noticeable during the third trimester of pregnancy, which gradually normalizes after the termination of pregnancy. Various complications do arise, which affect both the mother and her developing fetus. In the mother, miscarriages, delivery of baby via caesarian section, and other complications may result, whereas the fetus may be affected with congenital abnormalities, neonatal hypoglycemia, and even death. Treatment of GDM includes both non-pharmacological and pharmacological interventions. Pharmacological agents are employed when non-pharmacological interventions fail to achieve the desired target. Glyburide, insulin, and metformin are the commonly used pharmacological agents. 

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