In line with global trends, the incidence of gestational diabetes in Australia has increased markedly from a relatively stable documented rate in the first decade of this century (5·2% in 2010) to 14·0% in 2015 and 16·1% in 2018.1 The 2015 comparison is relevant as it represents the time at which the Australasian Diabetes in Pregnancy Society (ADIPS) changed the diagnostic process and criteria for gestational diabetes from the historic two-step approach to universal oral glucose tolerance testing (OGTT).