الفهرس 
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Abstract
Diabetes mellitus is a major cause of morbidity and mortality worldwide, with an increasing prevalence. Diabetes mellitus calcified into type 1, type 2 diabetes, other specific types of diabetes and gestational diabetes mellitus (GDM). GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. There are both foetal and maternal complications associated with GDM.
The management of GDM is important because appropriate therapy can decrease adverse pregnancy outcome. Effective treatment regimens consist of dietary therapy, exercise, self-blood glucose monitoring, and administration of insulin if target blood glucose values are not met with diet alone.
In our study we evaluated the effect of diet and exercise in glycemic control, the effect of oral hypoglycemic drugs as a treatment option for gestational diabetes women compared to conventional insulin therapy in glycemic control in 50 pregnant women with GDM in 24 to 28 weeks of gestation attend to out- patient clinic in Sohag university hospital in the period of May 2013: May 2014 where classified into 2 group of studied population according to control of blood sugar as following 70% were uncontrolled gestational diabetes mellitus (GDM) and 30% were controlled gestational diabetes mellitus (GDM).
Factor affecting controlled group of gestational diabetes mellitus (GDM).
Residency plays an important role in controlled of GDM where 86.7% of them from urban and 13.3% from rural. This was because of the difference in the degree of cultural awareness and educational between urban and rural areas.
The effect of treatment on controlling GDM depend on lifestyle modification (diet and/or exercise) where patients on diet therapy controlled 8 times than patients not on diet therapy and 29 times controlled on exercise therapy than not on exercise therapy.
With bearing in mind the limited numbers of cases, the controlled group were mainly with combination therapy where 46.7% on lifestyle modification (diet and/or exercise) and insulin therapy were most controlled groups in spite of patients on insulin therapy only were not controlled.
There were 26.7% patients controlled on combination only (insulin and metformin) therapy and 20% patients of our study controlled on lifestyle modification (diet and/or exercise) and combination (insulin and metformin) therapy with bearing in mind the limited number of cases.
Note that was found on a little number of researches about the importance of lifestyle modification as the basis of treat GDM in Sohag , so should make great efforts to improve the awareness and surveillance programs about management of GDM.
CONCLUSION & RECOMMENDATIONS
We conclude that glycaemic control during pregnancy in Sohag University Hospital was very poor. The degrees of control of blood sugar depend on awareness of women with gestational diabetes with different cultures and levels of education between urban and rural areas. The life style modification as nutrition and exercise play a big role in the process control in gestational diabetes. In this study show that the factor of nutrition and exercise play an important role in regulating blood sugar in the blood regardless of the types of medications used insulin or other oral hypoglycemic drugs. Insulin therapy only was not controlled in spite of whom on lifestyle modification (diet and/or exercise) and insulin therapy were most controlled groups. The combination (insulin and metformin) therapies only controlled about 26.7% of patients. But on lifestyle modification (diet and/or exercise) and combination (insulin and metformin) therapy were controlled about 20% of patient with bearing in mind the limited number of cases.
Recent studies have illustrated the importance of the use of metformin as treatment of GDM.
Recommendations:
Studies of GDM in Egypt are very defective and great efforts should be done to improve degree of awareness, drawbacks and effect of GDM.
Surveillance programmes should be submitted to diagnose and manage GDM.