Optimal glycemic control, fetal morbidity and monitoring protocols in gestational diabetes mellitus

Numerous studies have clearly demonstrated a significant association betwee n maternal glycemic control and adverse outcomes in pregnancies complicated by gestational diabetes. However, despite our understanding of the importa nce of stringent glucose control in the management of these pregnancies, th e definition of optimal glycemic control and monitoring protocols have yet to be firmly established. This article will review existing evidence in the literature regarding thresholds of glycemic control and risks for various neonatal complications. In addition, the role of various self-monitoring pr otocols and their impact on outcome will also be evaluated. Areas where fur ther investigations are needed in terms of glucose assessment will be highl ighted.