Gestational diabetes affects 2-3% of pregnancies and is characterized by carbohydrate intolerance that develops during pregnancy. Risk factors include maternal age over 25, family history of diabetes, prior macrosomia or stillbirth. Screening involves a glucose challenge test at 24-28 weeks of gestation. A diagnosis requires two abnormal values on a 3-hour oral glucose tolerance test. Treatment focuses on tight glycemic control through diet, exercise and possibly insulin to reduce risks of complications for both mother and baby like macrosomia, birth trauma and neonatal hypoglycemia.