Glycaemic control deteriorated in diabetes patients following the floods but was almost exclusively confined to patients taking insulin and was worst at 6-9 months following the event. Insulin-treated patients may need specific targeting in the event of a natural disaster.

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Based on these findings, we recommend that all women diagnosed with GDM should be assessed post-partum by an OGTT if we are to detect all the women who have abnormal glucose tolerance at this time. Those women with normal glucose tolerance also need counselling regarding the implications of the diagnosisofGDMandshouldreceiveadviceonrecommendations for lifestyle modification and follow-up, if we are to reduce their subsequent progression to Type 2 diabetes.In this large, multi-ethnic Australian group of women with gestational diabetes, relying on fasting glucose alone at 6-week post partum assessment would have missed 33% of mothers shown to have ongoing Type 2 diabetes and 76% of those with impaired glucose tolerance.

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