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The problem of screening and treating diabetes in pregnancy in a resource-poor country is explored. Although the burden of disease is high, diabetes contributes to higher perinatal mortality and morbidity and ultimately can lead to metabolic diseases when the offspring reaches adulthood. The mother is also more likely to develop full blown diabetes in later life with resulting diabetic morbidity and even mortality. Cheaper options for screening, including task shifting, are essential. In type 2 diabetes and gestational diabetes there are cheaper alternatives to insulin for treatment, such as diet, exercise, and oral glucose lowering agents such as metformin and glibenclamide.
Edward J. Coetzee (Fri,) studied this question.