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The prevalence of gestational diabetes is increasing in Australia. Non-pharmacological intervention with dietary measures and exercise is the mainstay of therapy in most cases, but insulin is increasingly necessary to achieve adequate glycaemic control in some women. Basal-bolus insulin is the optimal management strategy, but therapy needs to be individualised. Although there is mounting evidence for the efficacy and safety of metformin, the lack of long-term follow-up data has prevented it from being recommended by most experts in the field. women with gestational diabetes need long-term follow-up because of their increased risk of type 2 diabetes.
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Donovan et al. (2010) studied this question.
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