Neglected gestational diabetes: Risks and consequences

In German-speaking countries only about 10% of cases of gestational diabete s (GDM) are diagnosed because screening is not widely performed. Undiagnose d GDM leads to avoidable shortterm and long-term complications for the moth er and the offspring. The mothers are at increased risk for hypertensive co mplications of pregnancy, urinary tract infections, premature delivery and caesarean delivery. The unrecognized predisposition to diabetes can be foll owed by early manifestation of diabetes and diabetic sequelae later in life . The fetus developes hyperinsulinism and is at risk for macrosomia and int rauterine death. Newborns are at risk for prematurity and for characteristi c diabetogenic fetopathy with hyperinsulinism, delayed adaptation, hypoglyc emia, hypocalcemia, and hyperbilirubinemia. Malconditioning of the fetal is let cell organ in utero predisposes the child and adolescent to obesity, im paired glucose tolerance, and diabetes rater in life. Screening for GDM sho uld lead to the detection and treatment of one otherwise undiagnosed case p er 100 pregnancies. An undiagnosed case of GDM leads to costs of 106 693,- Euro while screening 100 women would cost E 214,to E 3600,- at most. Thus, a general screening policy for GDM would provide medical and economic benef its.