title: Pregnancy and diabetes management: advances and controversies.
abstract: BACKGROUND
  The treatment of diabetes in pregnancy has potentially far-reaching benefits for both pregnant women with diabetes and their children and may provide a cost-effective approach to the prevention of obesity, type 2 diabetes mellitus, and metabolic syndrome. Early and accurate diagnosis of diabetes in pregnancy is necessary for optimizing maternal and fetal outcomes.
  
  
  BACKGROUND
  Optimal control of diabetes in pregnancy requires achieving normoglycemia at all stages of a woman's pregnancy, including preconception and the postpartum period. In this review we focus on new universal guidelines for the screening and diagnosis of diabetes in pregnancy, including the 75-g oral glucose tolerance test, as well as the controversy surrounding the guidelines. We review the best diagnostic and treatment strategies for the pregestational and intrapartum periods, labor and delivery, and the postpartum period, and discuss management algorithms as well as the safety and efficacy of diabetic medications for use in pregnancy.
  
  
  CONCLUSIONS
  Global guidelines for screening, diagnosis, and classification have been established, and offer the potential to stop the cycle of diabetes and obesity caused by hyperglycemia in pregnancy. Normoglycemia is the goal in all aspects of pregnancy and offers the benefits of decreased short-term and long-term complications of diabetes.
authors.affiliation: Sansum Diabetes Research Institute, Santa Barbara, CA 93110, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Castorino
authors.forename: Lois
authors.initials: L
authors.lastname: Jovanovič
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000517:prevention & control; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D007774:Lactation; D058725:Peripartum Period; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000145:classification / Q000175:diagnosis / Q000517:prevention & control
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin