Transforming Gestational Diabetes Testing: New Guidelines for Australia

On June 23, 2025, the Australasian Diabetes in Pregnancy Society (ADIPS) released significant new guidelines for testing pregnant women for gestational diabetes, marking the first major change in over a decade. This update is expected to impact more than 280,000 women annually in Australia, aiming to reduce unnecessary diagnoses while effectively focusing on those who will benefit the most from care and intervention. Gestational diabetes, or gestational diabetes mellitus, is a common complication during pregnancy, characterized by elevated blood glucose levels that typically resolve after delivery. However, women diagnosed with gestational diabetes face a sevenfold increased risk of developing type 2 diabetes later in life.

The necessity of screening is underscored by the potential risks associated with untreated gestational diabetes, including macrosomia—where babies are born excessively large—and heightened chances of pre-eclampsia, a serious condition marked by high blood pressure and protein in urine during pregnancy. Treatment reduces these risks and has broader implications for maternal and child health.

Historically, routine screening is recommended for all pregnant women, a practice that will continue under the new guidelines. However, the updated recommendations aim to refine the screening process, focusing on balancing the benefits of diagnosis against the potential psychological and logistical burdens that a diagnosis can impose on women. Many women have expressed feelings of stigma and shame associated with a gestational diabetes diagnosis, along with difficulties accessing necessary healthcare support.

The updated guidelines introduce significant changes to the screening process. While all women without a prior diabetes diagnosis will still undergo screening at 24 to 28 weeks gestation via an oral glucose tolerance test (OGTT), the protocol for high-risk women will now include initial screening in the first trimester using a non-fasting blood test known as HbA1c. This test will help identify women who may require early intervention and reduce the number undergoing the OGTT more than once during their pregnancy. Moreover, the threshold for diagnosing gestational diabetes has been raised, which may result in fewer diagnoses overall.

Dr. Emma Thompson, a Senior Researcher at the University of Melbourne, and a co-author of the new guidelines, stated, “The changes reflect a comprehensive review of the latest evidence and aim to ensure that women receive the most appropriate care tailored to their individual risk profiles.” Dr. Thompson emphasized that the new recommendations have been developed with input from various stakeholders, including healthcare professionals and consumer advocacy groups.

In terms of international perspectives, screening practices for gestational diabetes vary significantly worldwide. For instance, the United States and Canada have adopted different testing criteria, reflecting regional variations in healthcare priorities and outcomes. According to the World Health Organization (WHO), these differences highlight the need for ongoing research and dialogue to optimize screening strategies globally.

The implications of these revised guidelines extend beyond individual health outcomes; they signal a broader shift towards personalized healthcare in maternity services. As healthcare systems evolve, providing targeted interventions can enhance maternal and fetal health outcomes while minimizing unnecessary interventions.

In conclusion, these new guidelines for gestational diabetes screening represent a forward-thinking approach aimed at improving care for pregnant women. By focusing on evidence-based practices and individual risk factors, Australia is setting a precedent for more nuanced and effective maternal healthcare. As these changes are implemented over the coming months, it will be crucial for healthcare providers to communicate effectively with patients about how these updates may affect their care pathways.