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Diabetes is a major national and global health concern. Gestational diabetes is the impaired carbohydrate metabolism first diagnosed in pregnancy, which has major health implications for the mother and her fetus. Many women with diabetes prior to childbearing age enter pregnancy with this chronic illness, which can have major implications on the outcome for her and her newborn. This article discusses the pathophysiology of gestational diabetes, diagnosis and management of the mother and newborn, maternal and fetal effects, and long-term considerations for the mother and her child.