Ideas in this flowchart

• Gestational diabetes mellitus is common in pregnancy and associated with maternal and fetal complications.
• The HAPO study demonstrated that gestational hyperglycemia is associated with adverse pregnancy outcomes.
• Maternal outcomes include pre-eclampsia and premature delivery.
• Fetal and delivery outcomes include large-for-gestational-age babies, interventional delivery, shoulder dystocia, and birth injury.
• Neonatal outcomes include hypoglycemia, hyperbilirubinemia, and the need for intensive neonatal care.
• Management includes lifestyle advice and commonly requires insulin.
• The treatment window is short.
• Early insulin initiation and titration are essential to quickly optimize glycemic control.
• Optimized glycemic control can reduce the risk of maternal and fetal complications.