Management of diabetes mellitus and hyperglycemia in pregnancy

Glucose metabolism disorders represent one of the most com­mon metabolic pathologies associated with pregnancy and are correlated with an increased risk of maternal and fe­tal complications. The rising prevalence of type 1 and type 2 diabetes, as well as obesity among women of re­pro­duc­tive age has led to a continuously increasing incidence of gestational diabetes and preexisting diabetes during preg­­nancy. Optimal management requires preconception coun­se­ling, strict glycemic control, frequent monitoring and a multidisciplinary approach. The main objective is to achieve adequate glycemic control, primarily through in­su­lin therapy, individualized nutritional intervention and regular physical activity. Insulin remains the treat­ment of choice both for preexisting diabetes and for ges­ta­tio­nal diabetes that does not respond to lifestyle mo­di­fi­ca­tions. The implementation of current clinical guide­lines sig­ni­fi­cantly reduces the risk of maternal-fetal com­pli­ca­tions and improves the long-term prognosis for both mother and child.