Proposal for the Reconsideration of the Definition of Gestational Diabetes

In 1997, the American Diabetes Association (ADA) announced a new diagnostic criterion for diabetes and set the definition of gestational diabetes mellitus (GDM). Before 1991, GDM was defined as “a transient abnormality of glucose tolerance during pregnancy” (2–4). However, the 1997 definition of GDM by the ADA includes diabetes diagnosed during pregnancy. This definition ignores the added risks to the mother and to the fetus when the mother has undiagnosed type 2 diabetes. We propose reconsideration of the definition, which would separate diabetes and slight abnormal carbohydrate, so-called GDM, to provide a better model of care for type 2 diabetic pregnant women. There are three problems concerning an undiagnosed type 2 diabetic woman that …