The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. 1-14% of pregnant women are affected by type 1 diabetes. Due to the increased incidence and proposed lowering of diagnostic thresholds, the cost of diabetes health care can be expected gestational age increases proportionally. The discussion of whether there is a benefit in the treatment of gestational diabetes is of greater importance today than in the past. Although it has long been known that women with pre-existing type 1 and type 2 diabetes are at increased risk for adverse maternal and fetal outcomes, the relationship between gestational diabetes and various perinatal risks is less clear. O'Sullivan and Mahan3 developed glucose tolerance testing criteria for the diagnosis of GDM almost 50 years ago. It is known that, if optimal care is not provided, women with GDM and elevated fasting blood glucose appear to be at risk for fetal overgrowth and perinatal morbidity.4 Over several decades, has there been a significant association of Milder forms of carbohydrate intolerance with macrosomia and adverse perinatal outcomes have been questioned and debated.5 Older studies, focusing on this issue, have interpreted that confounding variables including parity and maternal obesity , had perhaps not been taken into account in the analyzes or that the treatment had in fact been applied to the population described.6. Therefore, the effect of blood glucose on various outcomes may have been poorly estimated. The recent Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study has settled much of the debate over the relationship between varying degrees of maternal blood sugar and specific pregnancy outcomes.7 In this large-scale international study, women with fasting blood sugar levels up to 105 mg/dL were recorded. The researchers described the continuo...... middle of article ...... to new diagnostic thresholds based on relative risk should be adopted by expert consensus. The frequency of LGA infants and primary cesarean section rates as observed in the HAPO study are shown in Table 2. Evidence of any benefit from treating glucose levels below current diagnostic criteria is lacking. The studies seen above prove that treating even mild GDM with dietary intervention and insulin if necessary is effective. The need to establish such clinical evidence cannot be ignored as it affects the perception of healthcare advisories that consider the merits of treating the entire spectrum of GDM. . In an era where evidence-based medical practice should be a guiding principle, GDM can finally be seen as an entity for which recommendations can be based on data derived from clinical trials rather than expert opinion alone..