Issues With the Diagnosis and Classification of Hyperglycemia in Early Pregnancy

H. David McIntyre; David A. Sacks; Linda A. Barbour; Denice S. Feig; Patrick M. Catalano; Peter Damm; Aidan McElduff

doi:10.2337/dc15-1887

Considerations in the Management of Gestational Diabetes Mellitus

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.

Diabetes Care 2016 Jan; 39(1): 53-54. https://doi.org/10.2337/dc15-1887

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 (HbA_1c ≥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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