Definition, size of the problem, screening and diagnostic criteria: who should be screened, cost-effectiveness, and feasibility of screening.

The epidemic of obesity and increased prevalence of diabetes necessitates reconsideration of its definition and screening by separating type 2 diabetic women from women with gestational diabetes to provide a better model of care. The unique problems concerning an undiagnosed type 2 diabetic woman are not major issues in the gestational diabetic woman. This review underscores the need for a unique diagnosis for women with moderate to severe hyperglycemia and/or other evidence of long-standing diabetes complications, and the urgent need for more intensive surveillance and treatment than is otherwise available for gestational diabetic women.