Research Article

Gestational diabetes: a non-entity?

BMJ 1993; 306 doi: https://doi.org/10.1136/bmj.306.6869.37 (Published 02 January 1993) Cite this as: BMJ 1993;306:37
  1. R J Jarrett
  1. United Medical and Dental School, London.

    Abstract

    Screening for gestational diabetes is commonly recommended despite the absence of a common definition of gestational diabetes. Furthermore, there is no consensus about management or treatment. Those who recommend screening do so largely on the basis of fetal morbidity, which seems to be predominantly "macrosomia"--another term without an agreed definition. The implications of macrosomia in terms of actual morbidity are also not clear. R J Jarrett reviews the history of the subject and concludes that gestational diabetes is simply impaired glucose tolerance temporally associated with pregnancy. Its main importance is as a predictor of subsequent non-insulin dependent diabetes, but it fails the major tests for a condition suitable for a screening programme.