Gestational diabetes mellitus can occur in up to 16 percent of pregnancy.
Carbohydrate intolerance of GDM manifest itself after the 24 week, when the placenta starts to produce hormones that interfere insulin activity. Without adequate control of blood sugar GDM poses serious risk.

Women at risk must undergo full check ups for diabetes at the end of second trimester of pregnancy. An effective glucose challenge test is to measure the plasma glucose one-hour after 50gm oral glucose does. followed by full oral glucose tolerance test.

Five fundamentals to manage diabetes during pregnancy : diet, exercise, monitoring weight gain, and insulin dose.

Postprandial hyperglycemia contributes substantially to over all glycemic control and it plays a major role in the pathogenesis of long-term microvascular and macrovascular complication of diabetes.

Diabetic women are vulnerable to protein malnutrition during gestation. A diet that supplies the needs of pregnancy without including excessive weight gain based on individual's body weight and structure. Exercise benefits both the mother and the baby. It is neccesry for the over weight women to loose weight.

When the women with pre-pregnancy diabetes reports with an unplanned pregnancy, the first task to achieve  euglycemia with insulin plus diet and exercise. During the first trimester, fluctuation in glucose level occurs frequently. Consequently, overnight hypoglycemia may develop.
Placenta growth ceases around 36 week therefore insulin demand insulin demand increase very little there after.

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