title: Clinical diagnosis of gestational diabetes.
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).
authors.affiliation: Division of Endocrinology and Metabolism, Heritage Medical Research Centre, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Edmond A
authors.initials: EA
authors.lastname: Ryan
mesh_terms: D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis; D005951:Glucose Tolerance Test; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy