New Consensus Criteria for GDM

Problem solved or a Pandora's box?

  1. Robert G. Moses, MD
  1. From the South Eastern Sydney and Illawarra Area Health Service, Wollongong, New South Wales, Australia.
  1. Corresponding author: Robert G. Moses, robert.moses{at}sesiahs.health.nsw.gov.au.

For at least a generation there has been a divergence of opinions about gestational diabetes mellitus (GDM). On one hand were those who, on the basis of largely observational studies in humans and extrapolation of animal data, felt that women should be tested for GDM and have their diagnosed GDM treated. On the other hand, there were the “obskeptics” who felt that no significant action should be taken until evidence of benefits and risks was available. Clinicians of either persuasion undoubtedly have found developments over the last few years most exciting.

In 2005, Crowther et al. (1) published the results of the Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS). For women diagnosed with GDM, the rate of prespecified perinatal complications was lower for the women randomized to the intervention (treatment) group. In a recent publication, Landon et al. (2) found that women with mild glucose intolerance who were assigned to treatment had a significant reduction in prespecified complications, mainly related to fetal size.

Although universal testing for GDM was not applied in either study, the advantages of treatment …

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