Skip to main content
  • More from ADA
    • Diabetes
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care
  • Subscribe
  • Log in
  • My Cart
  • Follow ada on Twitter
  • RSS
  • Visit ada on Facebook
Diabetes Care

Advanced Search

Main menu

  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • Special Article Collections
    • ADA Standards of Medical Care
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • Special Article Collections
    • ADA Standards of Medical Care
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Journal Policies
    • Instructions for Authors
    • ADA Peer Review
  • More from ADA
    • Diabetes
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care

User menu

  • Subscribe
  • Log in
  • My Cart

Search

  • Advanced search
Diabetes Care
  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • Special Article Collections
    • ADA Standards of Medical Care
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • Special Article Collections
    • ADA Standards of Medical Care
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Journal Policies
    • Instructions for Authors
    • ADA Peer Review
Original Articles

Summary and Recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus

  1. Boyd E. Metzger, MD1,
  2. Thomas A. Buchanan, MD2,
  3. Donald R. Coustan, MD3,
  4. Alberto de Leiva, MD, PHD4,
  5. David B. Dunger, MBBS, MD, FRCP5,
  6. David R. Hadden, MD, FRCP6,
  7. Moshe Hod, MD7,
  8. John L. Kitzmiller, MD8,
  9. Siri L. Kjos, MD9,
  10. Jeremy N. Oats, DM10,
  11. David J. Pettitt, MD11,
  12. David A. Sacks, MD12 and
  13. Christos Zoupas, MD13
  1. 1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  2. 2Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, California
  3. 3Brown Medical School, Women and Infant's Hospital of Rhode Island, Providence, Rhode Island
  4. 4Department of Endocrinology, Hospital de la Santa Creui Sant Pau, Universitat Autònoma, Barcelona, Spain
  5. 5Department of Pediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, U.K.
  6. 6Regional Endocrinology and Diabetes Centre, Royal Victoria Hospital, Belfast, U.K.
  7. 7Perinatal Division, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  8. 8Division of Maternal-Fetal Medicine, Santa Clara County Health System, San Jose, California
  9. 9Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, Torrance, California
  10. 10Division of Maternity Services, The Royal Women's Hospital, Carlton, Victoria, Australia
  11. 11Sansum Diabetes Research Institute, Santa Barbara, California
  12. 12Department of Obstetrics and Gynecology, Kaiser Foundation Hospital, Bellflower, California
  13. 13Diabetes Center, Hygeia General Hospital, Athens, Greece
  1. Address correspondence and reprint requests to Boyd E. Metzger, MD, Northwestern University Feinberg School of Medicine, Tarry Building 15-735, 303 East Chicago Ave., Chicago, IL 60611. E-mail: bem{at}northwestern.edu
Diabetes Care 2007 Jul; 30(Supplement 2): S251-S260. https://doi.org/10.2337/dc07-s225
PreviousNext
  • Article
  • Figures & Tables
  • Info & Metrics
  • PDF
Loading

Article Figures & Tables

Tables

  • Table 1—

    Ambulatory glucose values in pregnant women with normal glucose tolerance

    StudySubjects (n)FastingPostprandial (60 min)Postprandial (peak)
    Paretti et al. (3)*5169 (57–81)108 (96–120)
    3.8 (3.2–4.5)6.0 (5.3–6.7)
    Yogev et al. (2)†5775 (51–99)105 (79–131)110 (68–142)‡
    4.2 (2.8–5.5)5.8 (4.4–7.3)6.1 (3.8–7.9)
    • Data are conventional and SI units (95% CI).

    • *

      ↵* Glucose measured by capillary glucose meter with values adjusted to reflect plasma concentration (3).

    • †

      ↵† Values obtained by continuous monitoring of interstitial fluid (2).

    • ‡

      ↵‡ The time of the “peak” postprandial glucose concentration = 70 min (44–96).

  • Table 2—

    Metabolic assessments recommended after GDM

    TimeTestPurpose
    Post-delivery (1–3 days)Fasting or random plasma glucoseDetect persistent, overt diabetes
    Early postpartum (around the time of postpartum visit)75-g 2-h OGTTPostpartum classification of glucose metabolism*
    1 year postpartum75-g 2-h OGTTAssess glucose metabolism
    AnnuallyFasting plasma glucoseAssess glucose metabolism
    Tri-annually75-g 2-h OGTTAssess glucose metabolism
    Prepregnancy75-g 2-h OGTTClassify glucose metabolism
    • *

      ↵* Classification of glucose metabolism by criteria recommended by the American Diabetes Association (8). OGTT, oral glucose tolerance test.

  • Table 1—

    Screening strategy for detecting GDM

    GDM risk assessment: Should be ascertained at the first prenatal visit
    • Low risk: Blood glucose testing not routinely required if all of the following characteristics are present:

      • Member of an ethnic group with a low prevalence of GDM

      • No known diabetes in first-degree relatives

      • Age <25 years

      • Weight normal before pregnancy

      • Weight normal at birth

      • No history of abnormal glucose metabolism

      • No history of poor obstetric outcome

    • Average risk: Perform blood glucose testing at 24–28 weeks using either:

      • Two-step procedure: 50 g glucose challenge test (GCT) followed by a diagnostic oral glucose tolerance test in those meeting the threshold value in the GCT.

      • One-step procedure: Diagnostic oral glucose tolerance test performed on all subjects.

    • High-risk: Perform blood glucose testing as soon as feasible, using the procedures described above if one or more of these are present:

      • Severe obesity

      • Strong family history of type 2 diabetes

      • Previous history of: GDM, impaired glucose metabolism, or glucosuria

                If GDM is not diagnosed, blood glucose testing should be repeated at 24–28 weeks or at any time a patient has symptoms or signs that are suggestive of hyperglycemia.
    • Reproduced with minor modifications from Metzger et al. (9). “Weight normal at birth” is an additional low-risk criterion that must now be met.

  • Table 2—

    Diagnosis of GDM by an oral glucose tolerance test

    Oral glucose load*
    100-g glucose†75-g glucose†
    Fasting‡95 mg/dl5.3 mmol/l95 mg/dl5.3 mmol/l
    1-h‡180 mg/dl10.0 mmol/l180 mg/dl10.0 mmol/l
    2-h‡155 mg/dl8.6 mmol/l155 mg/dl8.6 mmol/l
    3-h‡140 mg/dl7.8 mmol/l——
    • Data are from Metzger et al. (9).

    • *

      ↵* The test should be performed in the morning after an overnight fast of at least 8 h but not more than 14 h and after at least 3 days of unrestricted diet (≥150 g carbohydrate/day) and physical activity. The subject should remain seated and should not smoke throughout the test.

    • †

      ↵† Two or more of the venous plasma glucose concentrations indicated below must be met or exceeded for a positive diagnosis.

    • ‡

      ↵‡ The cutoff values are those proposed by Carpenter and Coustan (10) for extrapolation of the whole blood glucose values found by O'Sullivan and Mahan (11) to plasma glucose concentrations.

PreviousNext
Back to top

In this Issue

July 2007, 30(Supplement 2)
  • Table of Contents
  • Index by Author
Sign up to receive current issue alerts
View Selected Citations (0)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Diabetes Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Summary and Recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus
(Your Name) has forwarded a page to you from Diabetes Care
(Your Name) thought you would like to see this page from the Diabetes Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Summary and Recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus
Boyd E. Metzger, Thomas A. Buchanan, Donald R. Coustan, Alberto de Leiva, David B. Dunger, David R. Hadden, Moshe Hod, John L. Kitzmiller, Siri L. Kjos, Jeremy N. Oats, David J. Pettitt, David A. Sacks, Christos Zoupas
Diabetes Care Jul 2007, 30 (Supplement 2) S251-S260; DOI: 10.2337/dc07-s225

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Add to Selected Citations
Share

Summary and Recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus
Boyd E. Metzger, Thomas A. Buchanan, Donald R. Coustan, Alberto de Leiva, David B. Dunger, David R. Hadden, Moshe Hod, John L. Kitzmiller, Siri L. Kjos, Jeremy N. Oats, David J. Pettitt, David A. Sacks, Christos Zoupas
Diabetes Care Jul 2007, 30 (Supplement 2) S251-S260; DOI: 10.2337/dc07-s225
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • SUMMARY AND RECOMMENDATIONS—
    • PANEL I: PATHOPHYSIOLOGY AND EPIDEMIOLOGY
    • PANEL II: THERAPEUTIC INTERVENTIONS DURING PREGNANCY
    • PANEL III: OFFSPRING
    • PANEL IV: MATERNAL FOLLOW-UP
    • APPENDIX
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Tables
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Breastfeeding After Gestational Diabetes Pregnancy
  • Gestational Diabetes After Delivery
  • The Predisposition to Obesity and Diabetes in Offspring of Diabetic Mothers
Show more Original Articles

Similar Articles

Navigate

  • Current Issue
  • Standards of Care Guidelines
  • Online Ahead of Print
  • Archives
  • Submit
  • Subscribe
  • Email Alerts
  • RSS Feeds

More Information

  • About the Journal
  • Instructions for Authors
  • Journal Policies
  • Reprints and Permissions
  • Advertising
  • Privacy Policy: ADA Journals
  • Copyright Notice/Public Access Policy
  • Contact Us

Other ADA Resources

  • Diabetes
  • Clinical Diabetes
  • Diabetes Spectrum
  • Scientific Sessions Abstracts
  • Standards of Medical Care in Diabetes
  • BMJ Open - Diabetes Research & Care
  • Professional Books
  • Diabetes Forecast

 

  • DiabetesJournals.org
  • Diabetes Core Update
  • ADA's DiabetesPro
  • ADA Member Directory
  • Diabetes.org

© 2021 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.