Diagnosis of Gestational Diabetes Mellitus: A Different Paradigm to Consider

The recently completed National Institutes of Health (NIH) (1) consensus development conference on the diagnosis of gestational diabetes mellitus (GDM) found insufficient evidence to change from current practice to that recommended by the American Diabetes Association (2). The NIH final statement identified some key research gaps, the first mentioned of which was to “evaluate the diagnostic thresholds associated with an odds ratio (OR) for adverse outcomes of 2.0 in the [Hyperglycemia and Adverse Pregnancy Outcomes] HAPO study (as opposed to the OR of 1.75 that is currently recommended by the International Association of Diabetes in Pregnancy Study Groups [IADPSG]).” We currently have data that may assist in this consideration. The results herein reported are from a post hoc analysis of a prospective study carried out in 2010 (3) to determine the prevalence of GDM with the proposed IADPSG (4) criteria compared with the prevalence …