With the improvement of modern living conditions, the number of pregnant women with gestational diabetes is increasing. Gestational diabetes includes pre-pregnancy diabetes and gestational diabetes, as the name implies, the former is developed before pregnancy and the latter is developed after pregnancy. In contrast to pre-pregnancy diabetes, gestational diabetes has no obvious clinical symptoms such as “three more and one less”, so many patients take this disease lightly. In fact, regardless of the type of diabetes, poorly controlled blood sugar can be very harmful to both mother and baby, increasing the risk of miscarriage, premature birth, fetal malformation and intrauterine death, as well as increasing the chance of obstructed labor and cesarean delivery. In addition, as time goes by, the chances of type 2 diabetes and metabolic syndrome are significantly higher for both the mother and the child with gestational diabetes when they grow up. Therefore, every mother-to-be should have a glucose tolerance screening test on time, and pregnant women with high-risk factors, such as obesity, polycystic ovary syndrome, and a family history of diabetes, should pay more attention. How to confirm the diagnosis of gestational combined diabetes? Pregnant women should have a fasting blood glucose test at the first prenatal checkup after pregnancy is confirmed. If fasting blood glucose exceeds 7 mmol/L, or blood glucose exceeds 11.1 mmol/L 2 hours after drinking sugar water, or random blood glucose exceeds 11.1 mmol/L, the patient should be considered to have preconception diabetes. If the blood glucose is normal in the first maternity test, a 75g glucose tolerance test will be performed at 24-28 weeks of pregnancy, which is known as the sugar water test, in which blood is drawn three times before and one hour and two hours after taking sugar, and the blood glucose values should be below 5.1, 10.0 and 8.5mmol/L respectively. Any blood glucose value that meets or exceeds the above criteria is diagnosed as gestational diabetes. It is important to note that a normal diet should be consumed for 3 consecutive days before the test, that is, a daily carbohydrate intake of at least 150 g. Fasting for at least 8 hours the night before the test is recommended, and sitting still, abstaining from smoking and avoiding strenuous activity during the blood glucose test on the day of the test. How is it treated once diagnosed? The primary treatment for gestational diabetes is a well-controlled diet and moderate exercise therapy. A reasonably controlled diet is one that meets the energy needs of the mother and fetus while limiting the intake of carbohydrates, rather than blindly reducing intake to lower blood sugar. Once the intake is insufficient and starvation ketosis or even hypoglycemia occurs, not only the mother may suffer serious complications such as ketoacidosis, but the fetus may even suffer sudden fetal death in utero. In addition to diet control, exercise therapy is also required. The common method is walking, but also doing some yoga, gymnastics, swimming, etc. suitable for pregnant women. Pregnant women with pre-pregnancy diabetes, as well as pregnant women with gestational diabetes whose blood glucose cannot be controlled by diet alone, often require additional insulin therapy. Insulin does not pass through the placental barrier and does not affect the fetus, so the use of insulin therapy for pregnant women with diabetes is not restricted and is the drug of choice for controlling blood sugar during pregnancy. From a certain point of view, insulin is the baby’s protector for pregnant women with severe diabetes. The specific insulin dosage needs to be adjusted individually according to the blood sugar situation. During the adjustment period, hospitalization is often required to prevent hypoglycemia, and after the blood sugar is adjusted smoothly, the patient can be discharged from the hospital for outpatient treatment. During the treatment period, it is very important that each patient must learn to self-monitor their blood glucose, that is, use a blood glucose meter to monitor their own blood glucose at home. Pregnant women with newly diagnosed hyperglycemia, those with poor glycemic control and those on insulin therapy should monitor their blood glucose seven times a day, including 30 minutes before three meals, two hours after three meals and at night. In addition, the obstetrician will regularly check the patient’s urinary routine, liver and kidney function, blood lipids, ultrasound, fetal heart monitoring, fundus examination and other indicators to monitor fetal development and detect various comorbidities early. Pregnant women with poorly controlled blood glucose also need early fetal lung maturation treatment to reduce the incidence of neonatal respiratory distress syndrome. The exact timing of delivery and mode of delivery should be determined according to individual circumstances. Diabetes itself is not an indication for cesarean delivery. However, the chance of cesarean delivery is greatly increased in cases of poorly controlled blood sugar and large fetuses. How to follow up after delivery? At 6-12 weeks after delivery, patients with gestational diabetes should visit the hospital for another glucose tolerance test with 75g of oral glucose to assess the recovery of blood glucose after delivery. If the re-test is normal, a follow-up visit will be conducted at least every 3 years thereafter. You should also avoid high sugar and high fat diet in the future and develop a healthy and good lifestyle to reduce the chance of developing diseases such as type 2 diabetes. For those who applied insulin during pregnancy, the dose of insulin required after delivery is generally significantly reduced compared to that during pregnancy due to the hormonal changes in the body. In addition, insisting on breastfeeding can also help in the recovery of blood sugar.