Treatments of Gestational Diabetes Mellitus—How Can We Achieve Glycemic Targets?

Dear Colleagues,

I am pleased to invite you to read this Special Issue: “Treatments of Gestational Diabetes Mellitus—How Can We Achieve Glycemic Targets?”.

Gestational diabetes mellitus (GDM) is one of the common complications of pregnancy, and the frequency of GDM is increasing worldwide. The International Diabetes Federation’s estimates suggest that, globally, hyperglycemia in pregnancy affects about 15.8% of live births, with around 84% of these being due to gestational diabetes mellitus. GDM is defined as any glucose intolerance of variable severity with onset and first recognition occurring during pregnancy. Numerous scientific studies have shown that even mild hyperglycemia in pregnancy may adversely affect perinatal period and newborn and mother's health and is clinically important with regard to both short- and long-term maternal and fetal risks. One of the key studies on gestational diabetes was the HAPO (hyperglycemia and adverse pregnancy outcome) study results on pregnant women with mild hyperglycemia, which revealed that there was no risk threshold in the association of fetal macrosomia and glycemia. Currently, in most countries, there is a one-step diagnostic strategy. Most often, the diagnostic window is between 24 and 28 weeks of pregnancy. In addition, if a woman is at risk of hyperglycemia in pregnancy, according to most recommendations, a 75g Oral Glucose Tolerance Test (75 g OGTT) should be performed at the beginning of pregnancy. The basic element of treatment of GDM is lifestyle behavior change: nutrition therapy and physical activity during pregnancy. It should be emphasized that the diabetic diet is an element of healthy eating in pregnancy. However, in about half of women with gestational diabetes, insulin injections will be necessary to maintain glycemic targets. Metformin and glyburide should not be used as first-line agents, as both cross the placenta to the fetus.

Currently, it is still a challenge to look for a simple indicator of the risk of gestational diabetes in a healthy pregnant woman. The aim of the Special Issue is to provide an overview of the key glycemic targets for the treatment of GDM in self-monitoring with the use of a glucometer: both fasting and after a meal and time in range (TIR) when using continuous glucose monitoring (CGM). The prevention of gestational diabetes is also a key issue, especially with the use of modern technology like CGM and telemedicine. Another important aspect associated with gestational diabetes is post-partum follow up and long-term observation after GDM, especially in light of the evidence associated with an increased risk of type 2 diabetes and cardiovascular disease after GDM.

Therefore, researchers in the field of treatment of gestational diabetes are encouraged to submit their findings as original articles or reviews to this Special Issue.

Dr. Katarzyna Cyganek
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• gestational diabetes mellitus
• pregnancy
• glycemic targets
• pregnancy outcomes of gestational diabetes
• follow-up of gestational diabetes
• continuous glucose monitoring