High prevalence of DM and genetic predisposition to metabolic syndrome among Asians, particularly in Indian women, predisposes women to develop GDM and its complications. So, there is a need for cost-effective universal screening and diagnostic method. Unfortunately there is no international consensus on the screening and diagnostic criteria for GDM. The rationale of this review is to provide recent updates and to discuss the controversies of screening and diagnosis of GDM. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area [4]. The high rate implies that Indian population has a higher incidence of DM and impaired glucose tolerance and is at a greater risk of developing GDM. It is diagnosed at 16.3% in ≤ 16 weeks of gestation, 22.4% between 17-23 weeks and 61.3% after 23 weeks of gestation [5].
The HAPO study demonstrate that maternal hyperglycemia even at a level below that diagnostic of DM is associated with increased birth weight and macrosomia. An increase in morbidity during pregnancy with a likelihood of developing diabetes in future is associated with maternal hyperglycemia. This also has a direct impact on the developing fetal pancreas and remains a risk factor for developing DM in future [6].