Gestational diabetes mellitus (GDM) remains a major clinical challenge and is likely to remain so as the numbers of women with hyperglycemia in pregnancy continue to increase. The rising incidence has followed the changing demographic characteristics of pregnant women, such as older age and increasing body mass index, coupled with new stricter diagnostic criteria.1 While one may debate whether it is appropriate to medicalize the pregnancies of such a large proportion of women, a more pertinent question is how to manage their hyperglycemia to reduce fetal and maternal morbidity.