Diet and medical therapy in the optimal management of gestational diabetes mellitus.

Gestational diabetes mellitus (GDM), a common medical complication of pregnancy is increasing in prevalence among all populations in parallel with the global increase in obesity and type-2 diabetes mellitus (DM). Although controversy regarding the perinatal consequences of GDM continues, efforts to identify the severity of maternal glucose intolerance associated with clinically important adverse outcomes are ongoing. Medical therapies beyond the traditional 'standard' medical nutrition therapy (diet) or insulin are being explored (oral glyburide and metformin); however, less costly alternatives such as more intensive lifestyle modification need to be evaluated. Such approaches are also applicable after GDM and are known to delay or prevent progression to DM in these high-risk subjects.