**12. Conclusion**

Adequate control of blood pressure, use of statin, cessation of tobacco use, regular physical activity and exercise and possible loss of excess bodyweight for as long as possible are the core management aspects in diabetes. Judicious use of antihyperglycemic drugs requires consideration of various factors, especially hypoglycemia and effect on bodyweight and cardiovascular events. The aim should also be to achieve normalization of HbA1c for long time by loss of excess bodyweight for as long as possible, regular physical activity and exercise and using regularly the antihyperglycemic medications not having the risk of hypoglycemia. 'Dynamic dose adjustment of medications likely to cause hypoglycemia' helps to apply such principles by temporary use of sulfonylurea or insulin as rescue therapy. Apart from such clinical management and various research aspects, there are public health approaches to be considered as the top priority for the control of diabetes epidemic in the population. The diagnosis of gestational diabetes usually made at 24–28 weeks is applicable for the clinical management of mother and child and for possible primary prevention of diabetes later in the mother. From the public health perspectives, however, protection of the susceptible *in utero* population from maternal malnutrition or clinical or subclinical hyperglycemia right from the time of conception itself is particularly required to control diabetes epidemic at the population level. There is urgent need of campaigns and programmes for maintenance of optimal pre-pregnancy body weight, as per the recommended body mass index for the respective populations.
