Abstract
Treatment of gestational diabetes mellitus has been shown to reduce the risk of pregnancy and perinatal complications. The basis is the adjustment of lifestyle (diet, exercise, sleep, elimination of stress), which in most cases leads to satisfactory diabetes mellitus compensation.
If pharmacotherapy is required, metformin may be the drug of first choice, which has a good effect on high fasting blood glucose levels, especially in overweight or obese women. The addition of basal insulin is necessary in some women for whom metformin monotherapy is insufficient.
However, due to the combination with metformin, much smaller doses of insulin are usually sufficient than with insulin monotherapy and there is no escalation of insulin resistance. Adequate dietary modification, which includes reducing carbohydrate portions if necessary, results in postprandial glycemic control without the need for prandial insulin.
Women who maintain a healthy lifestyle even after childbirth and, in addition, breastfeed, have a significantly lower risk of subsequent development of type 2 diabetes mellitus.