Insights uncovered from experiencing a rise in the incidence of gestational diabetes at a Melbourne hospital

Excerpt

To the Editor: It is with great interest that we read the recent publication in Diabetologia entitled ‘New diagnostic criteria for gestational diabetes mellitus and their impact on the number of diagnoses and pregnancy outcomes’ [1], in which Koning et al address the contentious recent change in diagnostic criteria for gestational diabetes mellitus (GDM). In evaluating the impact of the WHO 2013 criteria compared with the WHO 1999 criteria, they identified that women diagnosed with GDM based on the new, lower fasting blood glucose criteria of 5.1–6.9 mmol/l had an increased risk of adverse outcomes if not treated, as compared with women with normal glucose tolerance. Hence, they concluded that the lower fasting blood glucose level criteria of ≥5.1 mmol/l is justified and should be adopted in the Netherlands, where their study was carried out. Following on from this, Koning et al expressed concern about relaxing the 2 h plasma glucose (2HG) criteria for GDM, suggesting further studies are required to assess the outcomes of women with a 2HG between 7.8 and 8.4 mmol/l, who would no longer receive treatment for GDM based on these new criteria. The article also describes a global increase in the incidence of GDM since adopting the WHO 2013 criteria, despite the lack of international consensus regarding which GDM diagnostic criteria to use. …