The pandemic of diabetes and its related complications continues unabated despite strides in understanding its pathophysiology and the availability of new therapeutic interventions. Approximately 80% of people with diabetes live in poor and developing countries, and many of them, especially those living in rural areas and small towns, are without access to adequate basic health care. Further as discussed in Chap. 6, the lack of access to adequate nutrition and the reduced opportunities for exercise in developing countries have created an obesity epidemic, which parallels the rising prevalence of diabetes and gestational diabetes (GDM). Unfortunately, there are scarce data regarding the short- and long-term health and socioeconomic consequences of gestational diabetes in these countries. On the basis of the experience of a diabetes health care provider in India, it is found that individuals and health care systems are unable to cope with the tremendous economic burden of this disease. It is essential that the health care planners in developing countries (1) make screening, diagnosis, and treatment of GDM and the preconception, antepartum, and postpartum care of women with type 2 diabetes (DM2) “available,” “accessible,” and, most importantly, “affordable” to their citizens. The aim of this chapter is to present what is known about the rising prevalence of diabetes and GDM in the developing countries of the “third world” and discuss the complex issues related to access to health care.