Gestational diabetes mellitus (GDM), glucose intolerance with onset or first recognition during pregnancy, has been increasing (1) and will increase further with widespread adoption of new diagnostic criteria recommended by the American Diabetes Association (ADA) (2). GDM, even at the milder end of the diagnostic spectrum, is associated with fetal macrosomia, neonatal adiposity, pre-eclampsia, and cesarean section (3), which can be reduced by diagnosis and treatment (4,5). Such treatment is not without cost (6), and an effective, relatively simple, inexpensive approach to prevention could result in significant savings to the health care system, not to mention decreasing morbidity. In this issue of Diabetes Care, D'Anna et al. (7) describe a randomized controlled trial (RCT) of such a potential prevention strategy.
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