Issues With the Diagnosis and Classification of Hyperglycemia in Early Pregnancy
- H. David McIntyre1⇑,
- David A. Sacks2,
- Linda A. Barbour3,
- Denice S. Feig4,
- Patrick M. Catalano5,
- Peter Damm6 and
- Aidan McElduff7
- 1Mater Research, The University of Queensland, Brisbane, Queensland, Australia
- 2Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA
- 3Divisions of Endocrinology, Metabolism and Diabetes and Maternal Fetal Medicine, University of Colorado, Denver, CO
- 4Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- 5Department of Reproductive Biology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH
- 6Center for Pregnant Women With Diabetes, Departments of Obstetrics and Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- 7Discipline of Medicine, The University of Sydney, Sydney, New South Wales, Australia
- Corresponding author: H. David McIntyre, david.mcintyre{at}mater.org.au.
In 2010, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) panel published consensus-based recommendations on the diagnosis and classification of hyperglycemia in pregnancy (1). Within that document, the recommendations regarding early pregnancy testing were designed to facilitate early detection and treatment of hyperglycemia (HbA1c ≥6.5% [48 mmol/mol], fasting venous plasma glucose ≥7.0 mmol/L, random plasma glucose ≥11.1 mmol/L with confirmation) that, outside pregnancy, would be classified as diabetes. The term “overt diabetes” was suggested to describe these women. Subsequently, the World Health Organization (WHO) adopted the IADPSG criteria with some modifications and promoted the use of the term “diabetes in pregnancy” (2) for this group.
Cognizant that milder degrees of hyperglycemia would also be detected by early pregnancy testing, the IADPSG also recommended that fasting …
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