Shared care: gestational diabetes

Gestational diabetes (GD) is a common problem in pregnancy with potentially serious adverse outcomes for the baby. The diagnosis also identifies women at increased risk of subsequently developing type 2 diabetes.

The uncertainty surrounding the level of glucose intolerance that should be treated as GD is highlighted. Strategies for screening are discussed, and the public health importance of GD as identifying women at increased risk of developing type 2 diabetes is raised and discussed. A simple strategy for the delivery of these interventions to women with a past history of GD is outlined.

Gestational diabetes offers an ideal opportunity to identify one high risk group at risk of developing type 2 diabetes. Type 2 diabetes can be prevented or delayed in high risk groups by attention to weight control, exercise and by modifying other risk factors. This can be effectively and efficiently done through primary care, however, monitoring follow up of women is the challenge.