Scientific Evidence for Different Options for GDM Screening and Management: Controversies and Review of the Literature

Table 7

Management of women included in RCTs.

	Glucose monitoring	Target value for glycemic control	Type of diet	Recommendations about exercise	Glucose values used for starting pharmacologic therapy based on target values
Garner et al., 1997 [39]	4 times	F: <4.4 mmol/l (80 mg/dL); 1 h: <7.8 mmol/l (140 mg/dL)	35 kcal/kg IBW/day	Not stated	2 or more values higher in 2 weeks
Langer et al., 2000 [40]	7 times	F: <5.0 mmol/l (90 mg/dL); preprandial: <5.3 mmol/l (95 mg/dl); 2 h: <6.7 mmol/l (120 mg/dL)	(i) 25 kcal/kg BW/day for obese women; (ii) 35 kcal/kg BW/day for nonobese women; (iii) 3 meals and 4 snacks; (iv) 40–45% of calories from carbohydrates	Not stated	1 or more preprandial or 2 h values higher in 1 week
Mecacci et al., 2003 [41]	9 times	F: <5.0 mmol/l (90 mg/dL); 1 h: <6.7 mmol/l (120 mg/dL)	ADA	Not stated	More than 50% values higher after 1 week
Schaefer-Graf et al., 2004 [42]	6 times	Intervention group: F: <4.5 mmol/l (80 mg/dL); 1 h: <6.1 mmol/l (110 mg/dL); Control group: F: <5.0 mmol/l (90 mg/dL); 1 h: <6.7 mmol/l (120 mg/dL)	(i) 25 kcal/kg BW/day for overweight women; (ii) 30 kcal/kg BW/day for normal weight women	Exercise after meals	Intervention group: (i) AC > 75th weeks; (ii)  mg/dL; (iii) 2 h ≥ 200 mg/dL; Control group: (iv) 2 or more values; (v) 4 profiles with at least 1 value higher in 2 weeks
Crowther et al., 2005 [16]	4 times	F: <5.5 mmol/l (99 mg/dL); 2 h: <7.0 mmol/l (126 mg/dL)	Dietary advice from a qualified dietician	Not stated	(i) 2 values higher in 2 weeks <35 weeks; (ii) 2 h >8.0 mmol/l (144 mg/dl) in 2 weeks >35 weeks; (iii) 1 value >9.0 mmol/l (162 mg/dl) in 2 weeks
Anjalakshi et al., 2007 [43]	Not specified	2 h: <6.7 mmol/l (120 mg/dL)	Medical Nutrition Therapy (MNT)	Not stated	1 value 2 h higher in 2 weeks
Landon et al., 2009 [17]	4 times	F: <5.3 mmol/l (95 mg/dL); 2 h: <6.7 mmol/l (120 mg/dL)	ADA recommendations	Not stated	(i) >50% values higher between 2 study visits; (ii) 1 random value >160 mg/dl (8.9 mmol/l); (iii) 1 F > 95 mg/dl; the patient’s caregiver initiated treatment (more or less 7 visits)
Ijäs et al., 2011 [44]	4 times	F: <5.3 mmol/l (95 mg/dL); 1.5 h: <6.7 mmol/l (120 mg/dL)	Dietary and lifestyle counselling	Not stated	2 values higher in 2–4 weeks
Balaji et al., 2012 [45]	4 times	F: <5.0 mmol/l (90 mg/dL); 2 h: <6.7 mmol/l (120 mg/dL); HbA1c: <6.0 g/dL	Medical Nutrition Therapy (MNT)	Not stated	1 value higher in 2 weeks
Mukhopadhyay et al., 2012 [46]	7 times	F: <5.0 mmol/l (90 mg/dL); 2 h: <6.7 mmol/l (120 mg/dL)	(i) 25 kcal/kg BW for obese women; (ii) 35 kcal/kg BW for nonobese women; (iii) 3 daily meals; 40–45% of calories from carbohydrates	Not stated	1 value higher in 2 weeks
Niromanesh et al., 2012 [47]	4 times	F: <5.3 mmol/l (95 mg/dL); 2 h: <6.7 mmol/l  (120 mg/dL)	(i) 15 kcal/kg BW for obese women; (ii) 22 kcal/kg BW for overweight women; (iii) 30 kcal/kg BW for normal weight women; (iv) 40 kcal/kg BW for underweight women; (v) 45% of calories from carbohydrates, 20% from protein, and 35% from fat; (vi) 3 meals and 3 snacks; (vii) Calories: 10% breakfast, 30% each lunch and dinner, and 30% snacks	30 minutes of walking per day	2 values higher in one week
Silva et al., 2010 [48]	4 times	F: <5.0 mmol/l (90 mg/dL); 1 h: <6.7 mmol/l (120 mg/dL)	(i) 25 kcal/kg BW/day for overweight women; (ii) 35 kcal/kg BW/day for normal weight women; (iii) 3 full meals and 4 light meals; (iv) 35–45% of calories from carbohydrates	Not stated	2 values higher after 1 week
Mesdaghinia et al., 2013 [49]	4 times	F: <5.3 mmol/l (95 mg/dL); 2 h: <6.7 mmol/l (120 mg/dL)	Dietary	Not stated	1 value higher in 1 week
Spaulonci et al., 2013 [50]	4 times	F: <5.3 mmol/l (95 mg/dL); 2 h: <6.7 mmol/l (120 mg/dL)	(i) 25–35 kcal/kg IBW based on pregestational BMI; (ii) 55% carbohydrates, 15% proteins, and 30% fat	30-minute walk 3 times a week	>30% values higher in 1 week
Behrashi et al., 2016 [53]	4 times	F: <5.0 mmol/l (90 mg/dL); 2 h: <6.7 mmol/l (120 mg/dL)	Education for lifestyle change (exercise and diet)	Education for lifestyle change (exercise and diet)	1 value higher in 1 week

F: fasting; GA: gestational age; IBW: ideal body weight; BW: body weight; BMI: body mass index.
and 1 hour after each main meal: breakfast, lunch, and dinner.
, before lunch and dinner, 2 hours after main meals, breakfast, lunch, and dinner, and at bedtime.
, preprandial before lunch and dinner, 1 and 2 hours after each main meal: breakfast, lunch, and dinner.
, preprandial before lunch and dinner, 1 hour after each main meal: breakfast, lunch, and dinner.
and 2 hours after each main meal: breakfast, lunch, and dinner.
and 1.5 hours after each main meal: breakfast, lunch, and dinner.
Diabetes Association, Medical Management of Pregnancy Complicated by Diabetes, 3rd Edition, Alexandria, Virginia; ADA, 2000, pp. 70–86.
Diabetes Association, Nutrition Recommendations and Interventions for Diabetes: A Position Statement of the American Diabetes Association; Diabetes Care 2008 Jan. 31 (Suppl. 1): S61–S78.
NW, The Management of Gestational Diabetes: A Review Article; Vasc Health Risk Manag. 2009; 5:153–64.