Gestational diabetes mellitus (GDM) requires prompt management after diagnosis to protect both mother and fetus. Treatment is guided by specific glycemic targets that must be sustained throughout pregnancy.
Initial management is built on lifestyle modification: an individualised nutrition plan developed with a registered dietitian nutritionist, alongside structured physical activity. Weight management is also addressed based on pregestational weight. Lifestyle change alone may suffice for many individuals — the complete, sequenced protocol specifies when and how to proceed beyond this.
After diagnosis of GDM, treatment starts with medical nutrition therapy, physical activity, and weight management, depending on pregestational weight, as outlined in this section.
Lifestyle behavior change is an essential component of management of GDM and may suffice as treatment for many individuals.
It is recommended that generally healthy people do at least 150 min of moderate-intensity aerobic activity each week during pregnancy and postpartum, preferably spread throughout the week.
Glucose goals are fasting plasma glucose <95 mg/dL (<5.3 mmol/L) and either 1-h postprandial glucose <140 mg/dL (<7.8 mmol/L) or 2-h postprandial glucose <120 mg/dL (<6.7 mmol/L).
DOI: 10.2337/dc26-S015