This article contains posts and extracts from the UK Midwives and Consumers email list, a discussion group for people interested in midwifery in the UK. Open to midwives, students, mothers, and anyone interested in improving maternity services in UK. Posts in these archives express the views of the individual authors, and not those of the Association of Radical Midwives. Unless otherwise stated, the comments are personal experiences rather than evidence-based research.

Gestational Diabetes

Gestational Diabetes Issues and References

Compiled by Jackie Bradshaw

The main issues of controversy in gestational diabetes:

This list of issues is from an extensive article, Gestational Diabetes: What is GD? by Kmom (
For more articles on Gestational Diabetes, see ‘All About Gestational Diabetes‘ by KMom (

  • Whether GD can be prevented or minimized through proactive action
  • When and how to diagnose GD – Universal testing, types of testing, reliability, optimal cut-off points, etc
  • How risky GD really is or is not (how great is the burden of illness or/and is intervention really justified?)
  • How cost effective treatment is (does it sufficiently reduce enough problems to justify the costs?)
  • How effective interventions really are (do they reduce the burden of illness or outcome significantly?)
  • Whether strong degrees of intervention used introduce more risk that the GD itself
  • The proper levels of GD dietary management – calories, vitamin/mineral supplementation, 5 or carbohydrate etc)
  • What levels of blood glucose are most desirable in GD (extremely tight control versus less tight control)
  • When insulin use becomes desirable (prophylactic insulin use for borderline cases etc)
  • Questions about research design and contradictory results from previous studies. What is the true incidence of GD?
  • Treatment protocols for preventing/delaying type 2 diabetes in the mother after birth.

Reading list

Where an article is available on the Web, a direct link is given.

American Diabetic Association (1996)’sguide/uritest.htm

Brundenell, J.M. (1982) Diabetic Pregnancy. (Ed) Progress in Obstetrics & Gynaecology, Vol 2. Edinburgh. Churchill Livingstone. Cited in; Sweet, B. (Eds) Mayes Textbook for Midwives, (1997) Balliere Tindall. London.

Buchanan, T.A. Kjos, S.L. (1999) Journal Clinical Endocrinology Metabolism. Jun;84(6):1854-7

Chia, Y.T. Chua, S. et al (1996) Singapore Journal Medicine. Dec;37(6):591-4

Crichton, M.A. Silverton, L.I. (1985) The Sweeter Side of Life: A Review of Diabetes and its Effects on Pregnancy. Midwifery. 1: 195 – 206 Cited in; Sweet, B. (1997) (Eds) Mayes Textbook for Midwives, Balliere Tindall. London.

Enkin, M. Keirse, J. Chalmers, I. (1992) A Guide to Effective Care in Pregnancy & Childbirth. Oxford University Press. Oxford.

Goer. H. (1995) Obsetric risk versus research realities. Bergin & Garvey. Westport.

Greco, P. Loverrom, G. (1994) Gynecoogy & Obstetrics. 37(4):242-5

Heddegard, M. et al (1996) Epidemiology. Jul;7(4):339-45

Henderson, C. Jones, K. (Eds) (1997) Essential Midwifery. Mosby. London.

Hodnett, E.D. Continuity of Caregivers for Care During Pregnancy And Childbirth. Cochrane Library. Issue 3, 1999. Oxford: Update Software.

Jackson, E.a. Francke, L. et al. (1996) Journal Family Practitioners. Oct;43(4):383-8

Kjos, S.L. (1994) Seminal Perinatolology. Oct;18(5):470-4

Jarret, R.J. (1993) Gestational Diabetes: a non-entity? British Journal of Medicine. 306 (6869):33-38. Cited in: Sweet, B. (Eds) Mayes Textbook for Midwives, (1997) Balliere Tindall. London.

Jones, M.W. Stone, L.C. (1998) Journal Perinatal & Neonatal Nursing Mar;11(4):13-24

Kerbel, D. Glazier, R. et al. (1997) Journal Medical Screening. 4(3):128-32

Kirkland, F. (1999) Preconceptual Care for Women with Diabetes. Journal of Diabetes Nursing. Vol 3 No 4.

Saint Vincent Declaration: (1989) WHO Regional Office for Europe. Diabetes Mellitus in Europe: a Problem at All Ages in All Countries, a Model for Prevention and Self-care, 10-12 October, St Vincent (Aosta), Italy

Shields, N. Turnbull, D. et al. (1998) Midwifery. Jun;14(2):85-93

Shivvers, S.A. Lucas, M.J. (1999) Journal Reproductive Medicine. Aug;44(8):685-8
Siccardi, D.C. Obstetrics & Gynecology Resident. The Federal University of Rio de Janeiro – Brazil.

Metzger, B.E. Coustan, D.R. (1998) (Eds.): Proceedings of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 21 (Suppl. 2):B1- B167

Okun, N. Verma, A. et al (1997) Canadian Family Physician. Jan;43(1):88-93

O’Sullivan, J. B. et al. The Potential Diabetic and her Treatment in Pregnancy. Obstetrics & Gyanaecology. 27 (5): 683-689. Cited in; Goer. H. (1995) Obsetric risk versus research realities. Bergin & Garvey. Westport.

Helton, M.R. Arndt, J. et al (1997) Journal Family Practitioners. Jun;44(6):556-61

Hinchcliff, S. Montague, S. (1988) Physiology for Nursing Practice, Balliere Tindall. London.

Sweet, B. (Eds) Mayes Textbook for Midwives, (1997) Balliere Tindall. London.

Hawthorne, G. Snodgrass, A. Tunbridge, M. (1994) Diabetes Resident Clinical Practitioner. Oct;25(3):183-90

Mironiuk, M. Kietlinska, Z. et al. (1997) Clinical Expert Obstetrics & Gynecology. 24(4):193-7
Rizzo, T. et al. (1991) Correlation Between Antepartum Maternal Metabolism and Intelligence of Offspring. New England Journal Of Medicine. 325:911-16.

Hallak, M. Tsalamandris, K. et al. (1996) Journal Reproductive Medicine. Nov;41(11):871-4

Vogel, N. Burnand, B. (2000) European Journal Obstetric Gynecology & Reprodctive Biology. Jul;91(1):29-36

Cox, M. Whittle, M.J. Byrne, A. et al. (1992) Prepregnancy Counselling: Experience from 1075 cases. British Journal of Obstetrics and Gynaecology, vol 99, no 11, November, pp 873-876

Dang, K. Homko, C. et al (2000) Journal Maternal & Fetal Medicine. Mar-

Emma Innes. Diabetic Nurse. Worcestershire Acute Hospitals Trust.

Jarret, R.J. (1993) Gestational Diabetes: a non-entity? British Journal of Medicine. 306 (6869):33-38.

Lyn Shepherd. Diabetic Link Midwife. Worcestershire Acute Hospitals Trust.

Mires, G.J. Williams, F.L. Harper, V. (1999) Department of Obstetrics & Gynaecology, Ninewells Hospital & Medical School, Dundee. UK. From Diabetic Medicine 1999, Feb; 16 (2);138-41

Walsh, M. (1999) Clincical Nursing & Related Sciences. 5th Ed. Balliere Tindall, London.

Internet Sources:

Clicking on the web address below will open each link in this window. Alternatively, you can click ‘Open in new window’ to open each link in its own window.

All About Gestational Diabetes‘ by KMom
Open in new window

Diabetes UK
Open in new window

Diabetic Medicine – the journal of Diabetes UK 
Diabetic Medicine – Open in new window

Should we screen for gestational diabetes? from the British Medical Journal, 20 September 1997
BMJ article – Open in new window

Diabetes Statistics from the U.S. Department of Health and Human Services
Diabetes Stats -Open in new window

Office for National Statistics
ONS – Open in new window

Contact-A-Family page on Diabetes Mellitus
CAF – Open in new window

Diabetes Care and Research in Europe – The Saint Vincent Declaration . Declaration arising from meeting Organized by WHO and IDF in Europe, 10-12 October 1989
Saint Vincent Declaration – Open in new window

Medscape – Open in new window

Understanding Gestational Diabetes – a practical guide to a healthy pregnancy – from the USA’s National Institute of Child Health and Human Development
Understanding GD – Open in new window

World Health Organization – Regional Office for Europe 
WHO – Open in new window

ManDET – Midwifery and Diabetes Educational Trust
MandDET – Open in new window

Nutrition Recommendations and Principles for People With Diabetes Mellitus , from the American Diabetes Association, published in Diabetes Care.
Nutrition article – Open in new window


Compiled by Jackie Bradshaw

AH updated 2 May 2002

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