Diagnostic and classification criteria for hyperglycemia in pregnancy

  The International Diabetes and Pregnancy Study Group has published a guideline on the diagnosis and classification of hyperglycemia in pregnancy.  The specific recommendations include the following: 1. At the initial prenatal visit, all or only high-risk women should have fasting blood glucose (FPG), glycated hemoglobin (HBA1C), or random blood glucose testing, depending on the population’s abnormal glucose metabolism background and local circumstances.  2. The diagnostic criteria for overt diabetes during pregnancy are FPG > or = 7.0 mmol/l, HBA1C > or = 6.5%, or random blood glucose > or = 11.1 mmol/l and confirmed by review.  3. The treatment and follow-up of overt diabetes mellitus should be the same as for patients with pre-existing diabetes mellitus. If the test results do not confirm the diagnosis of overt diabetes, such as FPG > or = 5.1 mmol/l, but less than 7.0 mmol/l, the diagnosis of gestational diabetes mellitus (GDM) should be made.  4. If FPG < 5.1 mmol/l, a 75 g OGTT should be performed at 24-28 weeks of gestation to test whether the patient has GDM. 5. Overt diabetes mellitus is defined as fasting glucose > or = 7.0 mmol/l. The diagnosis of GDM is defined as meeting one of the following criteria: FPG > or = 5.1 mmol/l, 1-hour postprandial glucose > or = 10.mmol/l and/or or 2-hour postprandial glucose level > or = 8.5 mmol/l. 6. Glucose metabolism screening is currently performed clinically at 24 to 28 weeks of gestation, and the International Diabetes and Pregnancy Study Group Consensus Committee has indicated that there is insufficient research evidence to confirm the additional benefit of diagnosing and treating GDM prior to this time.  7, All women with GDM or overt diabetes should receive glucose monitoring after delivery.