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Gestational diabetes mellitus is commonly defined as hyperglycemia with onset or first recognition during pregnancy. However, this definition of gestational diabetes does not exclude pregnant women with undiagnosed pre-existing diabetes that now accounts around 1% of diabetes mellitus cases in pregnancy. Prompt identification of pre-existing diabetes, if compared with women with gestational diabetes mellitus, is essential, for the reason that women with pre-existing diabetes are at risk of giving birth to infants with serious malformations, and adverse pregnancy outcomes are increased in this cluster, too. These include serious injury at birth, increased probability of cesarean delivery, and increased incidence of newborn admission in intensive care unit. The incidence of gestational diabetes is unfortunately increasing, it accounts for 90% of cases of diabetes mellitus in pregnancy, and it has strong association with adverse pregnancy outcomes. Risk factors connected to gestational diabetes mellitus include older age, family history and previous history of gestational diabetes mellitus, obesity, polycystic ovary syndrome and high blood pressure (American Diabetes Association, 2009; Hedderson and Ferrara, 2008). If untreated, it may lead to diverse complications, such as fetal hyperinsulinemia, increased weight at birth, higher rates of cesarian deliveries, shoulder dystocia, more neonatal hypoglycemia, and is associated with concomitant preeclampsia in pregnant women. Therefore, given that gestational diabetes may have long-term pathological consequences for both mother and the child, it is important that it is recognized and correctly managed. Treatment of gestational diabetes is aimed to maintain euglycemia and it involves regular glucose monitoring, dietary modification, life style changes, exercise, and, when necessary, pharmacotherapy. Insulin therapy is the first choice of treatment, although glyburide and metformin may be indicated, too. In women receiving pharmacotherapy scheduled monitoring of fetal well-being with antenatal tests should be pursued.

Treatment Considerations for Gestational Diabetes Mellitus and Long-Term Postpartum Options