Background
Australian Aboriginal women have a high prevalence of type 2 diabetes (T2DM) in pregnancy and gestational diabetes (GDM).

Aims
To review how screening practice affects the pregnancy data of all Indigenous women and their newborns living in Cape York, Queensland.

Methods
All medical charts of mothers and their neonates delivered in the regional hospital over two‐one‐year periods (2006 and 2008) were reviewed. Universal testing with an oral glucose tolerance test (OGTT) was introduced in 2007.

Results
Gestational diabetes (GDM) increased from 4.7 to 14.2%, and T2DM was similar (2.4 and 2.3%). There were 127 deliveries in 2006 and 134 in 2008. Testing rates with OGTT improved from 31.4% in 2006 to 65.6% in 2008. Mothers with diabetes in pregnancy (DIP) were older and heavier than non‐DIP mothers. Caesarean section rates were significantly higher in the DIP group compared with the non‐DIP group (66 vs 25%) in both time periods. The booking weight of DIP mothers decreased 16 kg, their babies normalised their weight, length and head circumference; respiratory distress and Apgar scores improved comparing the two periods. In DIP, infants >40% had hypoglycaemia; however, rates of serious complications were low. Rates of breastfeeding were similar between groups. Follow‐up rates for GDM improved from 16.6% in 2006 to 31.6% in 2008. Of those tested one‐third were diagnosed with T2DM.

Conclusion
The rate of GDM tripled after implementation of universal testing. Outcomes improved. There is still need for improvement in testing and follow‐up practices in relation to DIP.