ABSTRACT
This chapter describes the rationale and process of changing health policy of Gestational diabetes mellitus (GDM) screening and diagnosis in Israel, including the following steps. First, provision of locally relevant information for health policy decision making, based on the analysis of the Israeli Hyperglycemia and Adverse Pregnancy Outcomes study cohort data. Second, cost-effective assessment of implementation of the International Association of Diabetes and Pregnancy Study Group recommendation, based on the data from Clalit Health Services (CHS), the largest health maintenance organization in Israel. Third, changing health policy of GDM screening, diagnosis, and care in CHS. CHS will adopt the risk-stratification approach, stratifying the women diagnosed with GDM according to the new diagnostic criteria into high-, intermediate-, and low-risk subgroups. Women considered being in the low-risk group will be provided with lifestyle advice, including dietary counseling and physical exercise, and follow-up by their primary practitioners and consultant gynecologists.
