Twin Pregnancy With Gestational Diabetes Mellitus: A Double Whammy?

Twin pregnancies represent 1.5% of all pregnancies in Australia, and they have an increased risk of gestational diabetes mellitus (GDM). Singleton GDM and twin pregnancies both represent high-risk pregnancies, but optimal management of twin GDM pregnancies is not clearly defined. Between 2011 and 2015, 410 women with twin pregnancies gave birth at our institution, and 99 (24.1%) developed GDM during their pregnancy. In the same period, there were 2,639 singleton pregnancies complicated by GDM. GDM was diagnosed by the 75-g oral glucose tolerance test (OGTT) under the old Australasian Diabetes in Pregnancy Society guidelines (fasting glucose ≥5.5 mmol/L or 2-h glucose ≥8.0 mmol/L) (1). Women with GDM twin pregnancies were older, had a higher rate of preexisting hypertension, and were more likely to be from non–Anglo-European backgrounds than …