Context

The screening, diagnosis and treatment of gestational diabetes have been a contentious topic for at least 25 years, when Hunter and Keirse1 concluded, “Except for research purposes, all forms of glucose tolerance testing should be stopped.” This judgement was based on a lack of firm epidemiological evidence for benefit to the population, and the need for “population-based research to establish the true risk of sub-diabetic degrees of hyperglycaemia during pregnancy,” which should then be followed by ‘rigorous, randomized trials’ of therapy. In recent years the HAPO study established a continuum of adverse pregnancy outcomes associated with increasing maternal …