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Clinical Diagnosis of Gestational Diabetes

RYAN, EDMOND A. MD

Clinical Obstetrics & Gynecology:
doi: 10.1097/GRF.0b013e3182a8e029
Gestational Diabetes Mellitus
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).

Author Information

Division of Endocrinology and Metabolism, Heritage Medical Research Centre, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada

The author declares that there is nothing to disclose.

Correspondence: Edmond A. Ryan, MD, Division of Endocrinology and Metabolism, Heritage Medical Research Centre, Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada. E-mail: edmond.ryan@ualberta.ca

© 2013 by Lippincott Williams & Wilkins.