Gestational diabetes mellitus (GDM) is defined by the American Diabetes Association (2013) as ‘any degree of intolerance with onset or first recognition during pregnancy’
(pp S70–71). In New Zealand, gestational diabetes affects 3000–4000 women per annum; that is, between 4.9–6.6% of pregnancies. However, prevalence rates are sensitive to the definition and diagnostic criteria of GDM that is currently under debate. If undiagnosed or untreated, there may be significant negative consequences, both for short and long term, for the woman and/or her baby.
For the baby, the potential for macrosomia and neonatal hypoglycaemia is high, and there are possible intergenerational effects of exposure of the foetus to maternal diabetes. For the woman, GDM is associated with a high risk for type 2 diabetes with up to 50% of women developing type 2 diabetes within 10 years. Therefore, active screening, diagnosis and management of GDM during pregnancy are essential. Postnatal interventions that may reduce progression to type 2 diabetes in high-risk populations (in particular limiting weight gain) are important. Modification of risk factors and regular screening is an important aspect of postnatal education and ongoing care (see health literacy Standard 1).
