Introduction: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The prevalence range from 1 to 14% of all pregnancies, depending on the population studied and the diagnostic tests employed. Risk assessment for GDM should be undertaken at the prenatal visit. Women with clinical characteristics of GDM should undergo glucose testing as soon as possible. If they are found not to have GDM at that initial screening, they should be retested between 24 and 28 weeks of gestation. Women of average risk should have testing undertaken at 24-28 weeks of gestation.Low risk status requires no glucose testing. Risk factors of GDM include, obesity, history of diabetes in first degree relatives, previous history of diabetes, glycosusia, history of birth with more than 4 kg still birth or malformation, polyhydamnius, age more than 25 years, member of an ethnic group with a high prevalence of diabetes, maternal low birth weight.  GDM of any severity increases the risk of fetal macrosomia, neonatal hypoglycemia, heart hyperthrophy, jaundice, polycythemia, and hypocalcemia, obesity and stillbirth.

Introduction: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance occurring or detected for the first time during pregnancy. Hypertension occurring as a result of pregnancy is called pregnancy-induced hypertension (Pili), which is itself divided into two groups: gestational hypertension and pre-eclampsia. The aim of this study is to compare the incidence of hypertensive disorders in patients with GDM and controls. Methods: This is a case-control study of 2416 pregnant women attending 5 antenatal clinics attached to Tehran University of Medical Sciences. The universal two-step screening approach was used: first, all women underwent a 50-gram I-hour glucose challenge test; second, all women with a I-hour blood glucose concentration higher than 130mg/dl underwent a 100-gram, 3 hour oral glucose tolerance test. Carpenter and Capstan's criteria were used to diagnose GDM. 220 women with a normal glucose challenge test were chosen as controls. GDM cases and controls were matched for age, body mass index, parity, and gestational age. Results: 114 women overall were diagnosed with GDM. Mean age, BMI, and parity in GDM and control groups were 29.09±6.13 and 28.64±6.00 years, 27.43±4.33 and 26.64±1.8 kg/m2, and 1.79 and 1.52 births, respectively. Women with GDM had a higher prevalence of essential hypertension, PIR, and pre-eclampsia than matched controls. Conclusion: Our results show that hypertensive disorders are more common in women with GDM than in normoglycaemic controls of similar age, parity and BMI.

Despite progress in diabetes care and treatment, pregnancies in women with either type 1 or, type 2 DM are still associated with poorer outcomes with respect to healthy non diabetic women. Pregestational DM complicates 0.2- 0.6% of pregnancies, 35% had type1 and 66% had type 2 DM. In contrast to GDM, pre GDM is more serious because the potential effects of uncontrolled glycemic levels begins at fertilization and implantation, continue throughout pregnancy and remain as a postpartum threat during breast feeding.To prevent excess complications in mother and fetus, diabetic care and education must begin before conception.This is best accomplished by a multidisciplinary team that includes a diabetologist (internist), an obstetrician familiar with management of high risk pregnancy, diabetes educators including: Nurse, dietitian and social worker and other specialists as deemed necessary.Pregnant women with type 1 and type 2 diabetes should talk with a diabetes nutritionist, to determine their goals for daily calories, carbohydrates, nutritional balance in foods, and timing of eating throughout the day.The goals of preconception care are: involve and empower the patient in the management of her diabetes, achieve the lowest HbA1C test without excessive hypoglycemia, assure effective contraception until stable and acceptable glycemia is achieved and identify, evaluate and treat long-term diabetes complications such as retinopathy, nephropathy, neuropathy, hypertension and coronary disease.