Skip Navigation LinksHome > December 2013 - Volume 56 - Issue 4 > Clinical Diagnosis of Gestational Diabetes
Clinical Obstetrics & Gynecology:
doi: 10.1097/GRF.0b013e3182a8e029
Gestational Diabetes Mellitus

Clinical Diagnosis of Gestational Diabetes

RYAN, EDMOND A. MD

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Abstract

Gestational diabetes mellitus (GDM) diagnosis remains controversial. ACOG criteria are based on the long-term risk of maternal diabetes. ADA recently suggested diagnosing GDM with 1 elevated value on an oral glucose tolerance test based on a 1.75-fold risk of large-for-gestational age infants resulting in a 17.8% rate of GDM. Given the lack of neonatal-based outcomes for the traditional position and problems of reproducibility and benefit/harm balance of the ADA approach, an alternative is presented herein based on a 2-fold risk of a large-for-gestational age baby, requiring 2 separate abnormalities to reduce false positives giving a more balanced benefit/harm ratio (10% GDM rate).

© 2013, Lippincott Williams & Wilkins

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