Treatment of gestational diabetes: Current approaches

According to the National Diabetes Data Group, Gestational Diabetes (GD) is a glucose intolerance diagnosed during pregnancy. Despite a significant reduction in perinatal mortality observed in the last decade in pregnant women affected by GD, morbidity is essentially unchanged, and for this reason ad adequate therapy must be carried out. The first-line therapy is a diet, which must be set by a nutritionist on the basis of blood glucose testing and weight loss. If this therapeutic regimen fails, an appropriate insulin therapy must be set. It's preferable to administer rapid-insulin (about 50% of total units) before meals: particularly, 20% before breakfast, 40% before lunch and 40% before dinner. The remaining 50% of basal insulin is used to ensure the insulinization during the night and pre-prandial hours. Although ACOG and ADA don't recommend the use of oral hypoglycemic agents in pregnancy, recent scientific studies have provided a good basis for the efficacy and safety of these drugs to obtain future allies for metabolic control. © Copyright 2011, CIC Edizioni Internazionali.