Gestational diabetes affects 5-7% of all pregnancies and has an effect on care during pregnancy, as well as on outcomes for both mother and fetus. Its prevalence is rising, along with the background prevalence of obesity and type 2 diabetes. This is not surprising, considering that they are intertwined in a cycle whereby having one condition increases the risk of having the other, and that they can all be passed down through the generations. This article will discuss the pathophysiology of gestational diabetes, as well as methods of screening, diagnosis, and intervention; increased knowledge and optimisation of which have the potential to slow the amplifying intergenerational cycle of these conditions.