Published online by Cambridge University Press: 01 February 1999
Gestational diabetes mellitus (GDM) is defined as ‘carbohydrate intolerance of variable severity with onset or first recognition during pregnancy’. GDM affects approximately 4–10% of all pregnancies in the United States. Pregnancies complicated by GDM have both short and long term effects on the developing fetus. Studies have shown that elevated levels of glycaemia are associated with increased perinatal mortality. O'Sullivan et al. in his original work, found a four-fold higher rate of perinatal mortality in untreated women with gestational diabetes when compared to women with a normal glucose tolerance test in the same time period. Pettit et al., when studying Pima Indians, found a direct association between a 2-hour, 75g glucose load result and perinatal mortality. Evaluation of recent studies concerning gestational diabetes revealed relatively high rates of stillbirth and perinatal mortality. Thus, it is clear that lack of a therapeutic regimen for these patients will result in increased fetal mortality.