Diagnosis of gestational diabetes

Figures & data

Table I. Various thresholds for diagnosing gestational diabetes with 100 g, 3-h OGTT. Two or more elevated values are needed for diagnosis (mmol/L [mg/dL]).

Test interval	O’Sullivan [2]^a mmol/L	National Diabetes Data Group [4]^b	Carpenter & Coustan [5]^c
Fasting	5.0 (90)	5.8 (105)	5.3 (95)
1 h	9.2 (165)	10.6 (190)	10.0 (180)
2 h	8.0 (145)	9.2 (165)	8.6 (155)
3 h	7.0 (125)	8.0 (145)	7.8 (140)

^aVenous whole blood, Somogyi-Nelson technique, rounded to nearest 5 mg/dL.

^bCorrected for conversion from whole blood to plasma, based on rounded O’Sullivan values.

^cCorrected for conversion of whole blood to plasma and Somogyi-Nelson to enzymatic glucose concentration measurement, and based on original unrounded O’Sullivan values.

Figure 1. Associations between each of the three OGTT values and each of the four primary outcomes in the HAPO study. From HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358:1991–2002. Copyright ©2008 Massachusetts Medical Society. Reprinted with permission.

Table II. Rates (%) of adverse outcomes in HAPO subjects without and with GDM by IADPSG criteria [12] and untreated and treated mild GDMs in MFMU network randomized trial [21].

	Normal 75 g, 2 h OGTT [12]	GDM (IADPSG proposed criteria)^a	Untreated mild GDMs [21]^b	Treated mild GDMs [21]
LGA (birth weight > 90th percentile	8.3	16.2	14.5	7.1
Fetal hyperinsulinemia (cord C-peptide > 90^th percentile)	6.7	17.5	22.8	17.7
Neonatal adiposity (percent body fat > 90th percentile)	8.5	16.6	NA^c	NA^c
Preeclampsia	4.5	9.1	5.5	2.5
Shoulder dystocia/birth injury	1.3	1.8	4.0	1.5

^aAll differences significant at p < 0.01 or better.

^bAll differences significant at p < 0.02 or better.

^cPercent body fat not reported, but neonatal fat mass significantly lower in offspring of treated mothers.

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