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In general terms, we distinguish between diabetes mellitus in pregnancy (usually preexisting or diagnosed in the first half of pregnancy) and gestational diabetes (usually developed and diagnosed in the second half of pregnancy).
Details of treatment are presented in respective chapters. Generally speaking, most oral drugs are not proven to be safe during pregnancy with the exception of metformin and glyburide. Women with type 1 diabetes mellitus require insulin, and most women with type 2 diabetes mellitus will need some insulin as well. For gestational diabetes, the majority of patients are controlled with diet. In terms of pharmacotherapy, insulin but also metformin or glyburide can be the first choice, depending on patient preferences and individual patient circumstances.