This oration is given to honour Professor Jeremy Oates for his role in the establishment and more particularly, the development of the Australasian Diabetes In Pregnancy Society. HIs focus has always been on improving the provision of clinical care to pregnant women, and for today's oration, particularly women whose pregnancy is complicated by diabetes. Best practice in clinical care is difficult. It requires a wide knowledge base, excellent judgement and empathy with the patient. Anyone who believes they have 100% success is exceptional or a fool.
Our knowledge base is often limited because of inadequate, wrong or wrongly interpreted data. It can be biased as can our judgement, by our experience and/or personality type. Facts often come with implicit subtext which is not known to the person utilising those facts. Current practice is also compromised by the tendency towards “ one size fits all”; underpowered negative studies; or, poorly powered or poorly informed modelling. I will attempt to flesh out these concepts based on my own clinical and research journey in diabetes in pregnancy. I will suggest what I believe to be the most clinically important questions that need to be answered in relation to gestational diabetes.