Conventionally, gestational diabetes is treated with
dietary and lifestyle management, with the addition of
supplementary insulin if acceptable glycaemic levels are
not achieved (Fraser, 2009).
NICE (2008) recommend treatment with lifestyle
modification (diet and exercise) for 1–2 weeks; in
patients with a BMI >27 kg/m², they suggest calory
restriction and moderate exercise.
Blood glucose-lowering therapy should be
considered if near-normal glucose levels are not
achieved or if macrosomia is evident or suspected
from an ultrasound scan. Guidance suggests clinically
effective diabetes therapy includes oral antidiabetes
drugs (metformin and glibenclamide) and insulin
therapy using human insulin or rapid-acting analogues,
which should be tailored to individual glycaemic
profiles. Glycaemic targets for gestational diabetes
mirror those for women with pre-gestational diabetes