Gestational Diabetes Mellitus: Simplifying the International Association of Diabetes and Pregnancy Diagnostic Algorithm Using Fasting Plasma Glucose

Using a large retrospective study in Arab (80.1%) and South Asian (15.5%) pregnant women, Agarwal et al. (1) questioned the helpfulness of the full 2-h oral glucose tolerance test (OGTT), as recommended by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) for the diagnosis of gestational diabetes mellitus (GDM) (2). The IADPSG proposes measuring fasting plasma glucose (FPG), 1-h plasma glucose and 2-h plasma glucose, with respective thresholds of 5.1, 10.0, and 8.5 mmol/l; at least one of these thresholds must be met to diagnose GDM. Agarwal et al. suggest an FPG ≥5.1 mmol/l–based diagnosis of GDM and a defined FPG <4.4 mmol/l to exclude GDM; women meeting these criteria would therefore not require OGTT. According to …