title: Who's responsible for the care of women during and after a pregnancy affected by gestational diabetes?
abstract: Despite its increasing incidence and high conferred risk to women and their children, gestational diabetes mellitus (GDM) is managed inconsistently during and after pregnancy due to an absence of a systemic approach to managing these women. New guidelines for GDM testing and diagnosis are based on stronger evidence, but raise concerns about increased workloads and confusion in a landscape of multiple, conflicting guidelines. Postnatal care and long-term preventive measures are particularly fragmented, with no professional group taking responsibility for this crucial role. Clearer guidelines and assistance from existing frameworks, such as the National Gestational Diabetes Register, could enable general practitioners to take ownership of the management of women at risk of type 2 diabetes following GDM, applying the principles of chronic disease management long term.
authors.affiliation: Nutrition and Dietetics, Mater Research, Brisbane, QLD, Australia. shelley.wilkinson@mater.org.au.
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Wilkinson
authors.affiliation: Centre of Research Excellence in Primary Health Care Microsystems, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Siew S
authors.initials: SS
authors.lastname: Lim
authors.affiliation: Centre of Research Excellence in Primary Health Care Microsystems, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Upham
authors.affiliation: Department of General Practice, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Pennington
authors.affiliation: Centre for Physical Activity and Nutrition Science, Deakin University, Melbourne, VIC, Australia.
authors.forename: Sharleen L
authors.initials: SL
authors.lastname: O'Reilly
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, VIC, Australia.
authors.forename: Dino
authors.initials: D
authors.lastname: Asproloupos
authors.affiliation: Mater Clinical School, University of Queensland and Mater Medical Research Institute, Brisbane, QLD, Australia.
authors.forename: H David
authors.initials: HD
authors.lastname: McIntyre
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, VIC, Australia.
authors.forename: James A
authors.initials: JA
authors.lastname: Dunbar
mesh_terms: D001315:Australia; D003299:Cooperative Behavior; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000458:organization & administration; D005260:Female; D058006:General Practice; D005951:Glucose Tolerance Test; D019983:Guideline Adherence / Q000458:organization & administration; D006801:Humans; D015994:Incidence; D033183:Interdisciplinary Communication; D008019:Life Style; D008134:Long-Term Care; D008403:Mass Screening / Q000458:organization & administration; D011181:Postnatal Care / Q000458:organization & administration*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011295:Prenatal Care / Q000458:organization & administration*