Diabetes Mellitus in Pregnancy: An Update on the Current Classification and Management

Abstract

BACKGROUND: Diabetes mellitus is a common medical disorder in pregnancy. It contributes particularly to perinatal morbidity / mortality, and maternal morbidity. This review aims at improving maternal and neonatal health care especially in Sub-Saharan Africa by improving the knowledge of health practitioners on current evidences in the classification and management of diabetes mellitus in pregnancy.
METHODS: Relevant texts as well as online data bases including Pubmed, Google scholar, and African journal online, were searched for literatures related to the subject.
RESULTS: Classification of diabetes in pregnancy has been revised to reflect the various aetiological factors. Also, the diagnostic value of fasting plasma glucose has been lowered to mark the point at which dramatic increase in the microvascular complications of diabetes mellitus occurs. Morbidity and mortality associated with the condition would be reduced through proper management that involves preconception care, early antenatal booking, dedicated multidisciplinary antenatal care, and delivery in a center with neonatal facility. Furthermore, some oral glucose lowering agents have shown some safety after the first trimester and they have been found to give comparable result to insulin therapy.
CONCLUSION: The classification of diabetes mellitus in pregnancy has been revised. Its optimal management should involve multi-disciplinary inputs and may include oral hypoglycaemic agents. Knowledge of these by clinicians would improve maternal and neonatal health. 
KEY WORDS: Diabetes mellitus, pregnancy, diagnosis, preconception, antenatal, delivery, oral glucose lowering agents