These adaptations
include maternal glucose intolerance, altered glucose metabolism,
cortisol/growth hormone levels and may be compounded by reduced
physical activity and increased calorific intake during pregnancy.
GDM, which tends to develop in the 2nd or 3rd trimester of pregnancy,
has been attributed to an increase in perinatal morbidity and mortality,
although pregestational diabetes is known to have a greater association
with fetal anomalies than GDM [23-27].