Patient Question: High blood sugar at 7 weeks of pregnancy, first fasting 5.5, second fasting 5.1, is this gestational diabetes? Doctor: There are two types of gestational diabetes: one is diabetes already existed before pregnancy, and the other is new onset of diabetes at the time of pregnancy. At seven weeks of pregnancy, the monitoring index of blood glucose should be based on the diagnostic index of adult diabetes. If the fasting blood glucose is less than 7.0, pre-gestational diabetes can be excluded. Wait until 24-28 weeks for glucose tolerance test, by then if fasting blood glucose is greater than or equal to 5.1; or 1 hour after meal is greater than or equal to 10.0; or 2 hours after meal is greater than or equal to 8.5 can be diagnosed gestational diabetes (2014 Guidelines for Combined Gestational Diabetes). The fasting blood glucose level of pregnant women will gradually decrease as the number of weeks of gestation increases, so the blood glucose at the first maternity visit is not a diagnosis of gestational diabetes, but the blood glucose at the maternity visit can still indicate the chance of gestational diabetes at 24-28 weeks. The largest clinical study of gestational diabetes in China (published in Diabetes Care 2013) showed that women with a fasting glucose greater than or equal to 5.1 at their first delivery had a 39.8% risk of having gestational diabetes diagnosed by OGTT at 24-28 weeks, much higher than women with a fasting glucose less than 4.1. Therefore, although you cannot diagnose gestational diabetes now, you still should not take it lightly and need to improve your 75g glucose tolerance test at 24-28 weeks.