4.2.0.0 Lifestyle Man­age­ment

After di­ag­no­sis, treat­ment starts with med­i­cal nu­tri­tion ther­apy, phys­i­cal ac­tiv­i­ty, and weight man­age­ment de­pend­ing on preges­ta­tion­al weight, as out­lined in the sec­tion below on pre­ex­ist­ing type 2 di­a­betes, and glu­cose mon­i­tor­ing aim­ing for the tar­gets rec­om­mend­ed by the Fifth In­ter­na­tion­al Work­shop-‍Con­fer­ence on Ges­ta­tion­al Di­a­betes Mel­li­tus (36):

Fast­ing <95 mg/dL (5.3 mmol/‍L) and ei­ther

One-‍hour post­pran­di­al <140 mg/dL (7.8 mmol/‍L) or

Two-‍hour post­pran­di­al <120 mg/dL (6.7 mmol/‍L)

De­pend­ing on the pop­u­la­tion, stud­ies sug­gest that 70–85% of women di­ag­nosed with GDM under Car­pen­ter-‍ Cous­tan or Na­tion­al Di­a­betes Data Group (NDDG) cri­te­ria can con­trol GDM with lifestyle modiļ¬cation alone; it is an­tic­i­pat­ed that this pro­por­tion will be even high­er if the lower In­ter­na­tion­al As­so­ci­a­tion of Di­a­betes and Preg­nan­cy Study Groups (IADPSG) (37) di­ag­nos­tic thresh­olds are used.