Preventive and Therapeutic Strategies for Gestational Diabetes: A Literature Review
DOI:
https://doi.org/10.53770/amhj.v5i3.612Keywords:
Gestational Diabetes, Prevention, Therapy, PregnancyAbstract
Gestational diabetes is a glucose intolerance disorder that arises during pregnancy and is one of the most common obstetric complications globally. Its increasing prevalence is closely linked to high rates of obesity, unhealthy dietary patterns, physical inactivity, and advanced maternal age, particularly in developing countries like Indonesia, which still face limitations in screening and maternal healthcare services. This condition has both short-term and long-term impacts, including an increased risk of type 2 diabetes in both mothers and their children. This article presents a systematic literature review of preventive and therapeutic strategies for managing gestational diabetes, evaluating their effectiveness and potential for implementation. The method employed is a qualitative descriptive literature review, based on scientific articles from the past decade, obtained from databases such as PubMed, Scopus, and Garuda. The review findings indicate that the most effective preventive strategy is lifestyle modification, such as adopting a healthy diet and engaging in light physical activity, especially when implemented early in pregnancy or even before conception, which can reduce the risk of gestational diabetes by up to 25%. Therapeutic strategies include medical nutrition therapy, the use of insulin or metformin, self-monitoring of blood glucose, as well as education and psychosocial support. The use of digital technologies, including mobile applications and telehealth services, has also been shown to improve patient adherence and engagement. A holistic approach that integrates both preventive and therapeutic efforts continuously is considered the most effective in reducing complications and long-term risks. However, challenges such as limited access to healthcare services, low health literacy, and a shortage of trained healthcare personnel remain obstacles in Indonesia. Therefore, cross-sector collaboration among healthcare professionals, families, and policymakers is crucial to optimize the contextual and sustainable management of gestational diabetes.
References
Aoyama, K., Nakajima, Y., Meguro, S., Sato, Y., Goto, R., Hida, M., Arimitsu, T., Kasuga, Y., Tanaka, M., & Itoh, H. (2023). Efficacy and safety of a telemedicine system in subjects with gestational diabetes mellitus (TELEGLAM): Study protocol for a randomized controlled trial. Heliyon, 9(11), e22504. https://doi.org/10.1016/j.heliyon.2023.e22504
Balducci, S., Sacchetti, M., Haxhi, J., Orlando, G., D’Errico, V., Fallucca, S., Menini, S., Pugliese, G. (2014). Physical Exercise as Therapy for Type 2 Diabetes. Diabetes/Metabolism Research and Reviews, 32(30), 13–23. https://doi.org/10.1002/dmrr
Buschmann, C., Unverdorben, L., Knabl, J., Hutter, S., Meister, S., Beyer, S., ... & Ganster, F. (2024). Placental expression of inflammatory Galectin-12 is associated with gestational diabetes. Journal of Reproductive Immunology, 163, 104240. https://doi.org/10.1016/j.jri.2024.104240
Chen, S., Cao, M., Liu, K., & Gu, Y. (2025). The Impact of Exercise during Pregnancy on Maternal and Offspring Outcomes in Gestational Diabetes Mellitus. Biocell, 49(2), 181–198. https://doi.org/10.32604/biocell.2025.058745
Deitch, J. M., Lee, I. L., Yates, C. J., Kathpal, E., Lawton, P., Shahid, I., ... & Kevat, D. (2024). Simplified gestational diabetes screening with a triaging fasting plasma glucose reduces the burden of oral glucose tolerance tests during pregnancy–A large tertiary comparative cohort study. Diabetes Research and Clinical Practice, 209, 111120. https://doi.org/10.1016/j.diabres.2024.111120
Guglielmini, G., Falcinelli, E., Piselli, E., Mezzasoma, A. M., Tondi, F., Alfonsi, L., De Luca, C., Fino, V., Favilli, A., Parrettini, S., Minuz, P., Torlone, E., Gresele, P., & Gerli, S. (2025). Gestational diabetes mellitus is associated with in vivo platelet activation and platelet hyperreactivity. American journal of obstetrics and gynecology, 232(1), 120.e1–120.e14. https://doi.org/10.1016/j.ajog.2024.04.003
Haque, M. M., Tannous, W. K., Herman, W. H., Immanuel, J., Hague, W. M., Teede, H., Enticott, J., Cheung, N. W., Hibbert, E., Nolan, C. J., Peek, M. J., Wong, V. W., Flack, J. R., Mclean, M., & Sweeting, A. (2024). Articles Cost-effectiveness of diagnosis and treatment of early gestational diabetes mellitus : economic evaluation of the TOBOGM study, an international multicenter randomized controlled trial. EClinicalMedicine, 71, 102610. https://doi.org/10.1016/j.eclinm.2024.102610
Kukkonen, A., Hantunen, S., Voutilainen, A., Ruusunen, A., Uusitalo, L., Backman, K., ... & Keski-Nisula, L. (2024). Maternal caffeine, coffee and cola drink intake and the risk of gestational diabetes–Kuopio Birth Cohort. Primary Care Diabetes, 18(3), 362-367. https://doi.org/10.1016/j.pcd.2024.02.005
Liu, X., Zhu, Y., Seamans, M., Nianogo, R., Janzen, C., Fei, Z., & Chen, L. (2024). Gestational diabetes mellitus and risk of neurodevelopmental disorders in young offspring: does the risk differ by race and ethnicity? American Journal of Obstetrics and Gynecology MFM, 6(1), 101217. https://doi.org/10.1016/j.ajogmf.2023.101217
Mayne, I. K., Tyzack-Clark, H. M., & McGovern, A. P. (2023). Studies are needed to support optimal insulin dose titration in gestational diabetes mellitus: A systematic review. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 17(4), 102746. https://doi.org/10.1016/j.dsx.2023.102746
McLaren Jr, R. A., Ruymann, K. R., Ramos, G. A., Osmundson, S. S., Jauk, V., & Berghella, V. (2022). Early screening for gestational diabetes mellitus: a meta-analysis of randomized controlled trials. American journal of obstetrics & gynecology MFM, 4(6), 100737. https://doi.org/10.1016/j.ajogmf.2022.100737
Milluzzo, A., Manuella, L., Frittitta, L., & Sciacca, L. (2024). Efficacy of a phone reminder to improve adherence to post-partum glucose tolerance testing after gestational diabetes and clinical predictors of post-partum follow-up compliance. Diabetes Research and Clinical Practice, 210, 111653. https://doi.org/10.1016/j.diabres.2024.111653
Moreno-Castilla, C., Mauricio, D., & Hernández, M. (2016). Role of Medical Nutrition Therapy in the Management of Gestational Diabetes Mellitus. Current Diabetes Reports, 16(4), 1–9. https://doi.org/10.1007/s11892-016-0717-7
Nakshine, V. S., & Jogdand, S. D. (2023). A Comprehensive Review of Gestational Diabetes Mellitus: Impacts on Maternal Health, Fetal Development, Childhood Outcomes, and Long-Term Treatment Strategies. Cureus, 15(10), e47500. https://doi.org/10.7759/cureus.47500
Olga, L., Sovio, U., Wong, H., Smith, G. C., & Aiken, C. E. (2024). Maternal high body mass index, but not gestational diabetes, is associated with poorer educational attainment in mid-childhood. American Journal of Obstetrics and Gynecology, 231(1), 120.e1-120.e9. https://doi.org/10.1016/j.ajog.2023.11.1227
Phaloprakarn, C., & Suthasmalee, S. (2023). Effect of prenatal counseling on postpartum follow-up and contraceptive use in women with gestational diabetes mellitus: a randomized controlled trial. American Journal of Obstetrics and Gynecology MFM, 5(10), 101107. https://doi.org/10.1016/j.ajogmf.2023.101107
Phelan, S., Jelalian, E., Coustan, D., Caughey, A. B., Castorino, K., Hagobian, T., Muñoz-Christian, K., Schaffner, A., Shields, L., Heaney, C., McHugh, A., & Wing, R. R. (2023). Randomized controlled trial of prepregnancy lifestyle intervention to reduce recurrence of gestational diabetes mellitus. American Journal of Obstetrics and Gynecology, 229(2), 158.e1-158.e14. https://doi.org/10.1016/j.ajog.2023.01.037
Siddiqui, R., & McAdams, C. J. (2024). Challenges in the management of gestational diabetes mellitus in anorexia nervosa. Psychiatry Research Case Reports, 3(1), 100215. https://doi.org/10.1016/j.psycr.2024.100215
Sperling, M. M., Leonard, S. A., Blumenfeld, Y. J., Carmichael, S. L., & Chueh, J. (2023). Prepregnancy body mass index and gestational diabetes mellitus across Asian and Pacific Islander subgroups in California. AJOG Global Reports, 3(1), 100148. https://doi.org/10.1016/j.xagr.2022.100148
Suastika, A. V., Widiana, I. G. R., Fatmawati, N. N. D., Suastika, K., Paulus, I. B., & Sujaya, I. N. (2024). The role of probiotics and synbiotics on treatment of gestational diabetes: systematic review and meta-analysis. AJOG Global Reports, 4(1), 100285. https://doi.org/10.1016/j.xagr.2023.100285
Sukawana, W., Sukarja, M., & Wedri, M. (2016). Senam Kaki Meningkatkan Kelembaban Kulit Kaki Pada Diabetisi. Senam Kaki Meningkatkan Kelembaban Kulit Kaki Pada Diabetisi. Jurnal Gema Keperawatan, 9(1), 44–49.
Thomas, L. V., Jurkovitz, C. T., Zhang, Z., Fawcett, M. R., & Lenhard, M. J. (2024). Neighborhood Environment and Poor Maternal Glycemic Control–Associated Complications of Gestational Diabetes Mellitus. AJPM Focus, 3(3), 1–10. https://doi.org/10.1016/j.focus.2024.100201
Tsironikos, G. I., Potamianos, P., Zakynthinos, G. E., Tsolaki, V., Tatsioni, A., & Bargiota, A. (2023). Effectiveness of Lifestyle Interventions during Pregnancy on Preventing Gestational Diabetes Mellitus in High-Risk Women: A Systematic Review and Meta-Analyses of Published RCTs. Journal of clinical medicine, 12(22), 7038. https://doi.org/10.3390/jcm12227038
Usman, T. O., Chhetri, G., Yeh, H., & Dong, H. H. (2023). Beta-cell compensation and gestational diabetes. Journal of Biological Chemistry, 299(12), 105405. https://doi.org/10.1016/j.jbc.2023.105405
Wang, X., Lan, Y., Li, N., Gao, J., Meng, D., & Miao, S. (2024). Associations of educational attainment with gestational diabetes mellitus and the mediating effects of obesity: A Mendelian randomization study. Heliyon, 10(7), e29000. https://doi.org/10.1016/j.heliyon.2024.e29000
Wong, M. M. H., Yuen-Man Chan, M., Ng, T. P., & Louie, J. C. Y. (2024). Impact of carbohydrate quantity and quality on maternal and pregnancy outcomes in gestational diabetes mellitus: A systematic review and meta-analysis. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 18(1), 102941. https://doi.org/10.1016/j.dsx.2024.102941
Yao, D., Shen, C., Yu, J., Tang, J., Zhang, H., Xu, X., ... & Cheong, L. Z. (2024). Proteomic analysis of milk fat globule membrane proteins in mature human milk of women with and without gestational diabetes mellitus. Food Chemistry, 445, 138691. https://doi.org/10.1016/j.foodchem.2024.138691
Yu, J., Ren, J., Ren, Y., Wu, Y., Zeng, Y., Zhang, Q., & Xiao, X. (2024). Using metabolomics and proteomics to identify the potential urine biomarkers for prediction and diagnosis of gestational diabetes. EBioMedicine, 101, 105008. https://doi.org/10.1016/j.ebiom.2024.105008
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