Unhealthy lifestyles and gestational diabetesBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5549 (Published 30 September 2014) Cite this as: BMJ 2014;349:g5549
- Sara J Meltzer, associate professor of medicine and obstetrics and gynecology
- 1McGill University, M9.22, McGill University Health Centre-Royal Victoria Hospital, 687 Pine Ave, W Montreal, QC, Canada H3A 1A1
- Correspondence to:
Gestational diabetes mellitus is a growing problem in developed and developing countries.1 2 In a linked paper, Zhang and colleagues (doi:10.1136/bmj.g5450) report important information to help women protect themselves before and during pregnancy and reduce the enduring harm to both mothers and babies associated with gestational diabetes.3
The true incidence of gestational diabetes is difficult to know. There are wide regional and ethnic variations, and the criteria for diagnosis have been highly variable.4 This inconsistency has led WHO to reassess the diagnostic criteria for gestational diabetes. In 2013, WHO recommended screening for gestational diabetes (universally when possible) with the 75 g oral glucose tolerance test, with threshold values for diagnosis recommended initially by the IADPSG (International Association of the Diabetes and Pregnancy Study Groups): fasting plasma glucose concentration of ≤5.1 mmol/L, 10.0 mmol/L one hour postload, and 8.5 mmol/L two hours postload.5 Any one value at or above the threshold values would indicate gestational diabetes.
It would considerably improve evaluation of therapeutic interventions and long term outcomes if all investigators and studies used the same diagnostic thresholds, recognizing that there might be different country specific criteria used in a screening step before …