Early Gestational Diabetes Mellitus: an Update about Its Current Status

Gestational diabetes mellitus (GDM) frequently complicates pregnancy and is associated with adverse outcomes both in the mother and her offspring. Usually, screening for GDM is recommended in the second/third trimester of pregnancy but GDM occurring in the first trimester is being increasingly reported and this is called as early gestational diabetes mellitus (eGDM). Thus, GDM can be classified as conventional gestational diabetes mellitus (cGDM) and early gestational diabetes mellitus (eGDM). The prevalence of eGDM varies widely due to different criteria being used. Women with eGDM present with a unique metabolic profile. The pathophysiology of eGDM appears to be the combined effects of beta-cell dysfunction and insulin resistance. Increased occurrence of adverse pregnancy outcomes, higher incidence of postpartum dysglycemia and a greater need for insulin use have been reported in women with eGDM. The Treatment Of BOoking Gestational diabetes Mellitus (ToBOGM) study, which is a randomised control trial, showed the benefits of early treatment in women with eGDM in terms of better neonatal outcomes. We have also identified some of the gaps in eGDM literature for future research in this field.