On March 6 of this year, the National Institutes of Health (NIH) issued a statement on the diagnosis of gestational diabetes mellitus (GDM), suggesting that the diagnosis of GDM still requires a two-step process: first, a 50 g glucose load test for initial screening, that is, oral administration of 50 g of glucose, and blood glucose testing 1 h later, if the blood glucose level ≥ 7.8 mmol/L is abnormal, abnormal patients need to further do 75 g or 100 g Glucose tolerance test (OGTT) is performed to confirm the diagnosis, which measures fasting blood glucose (FBG), 1 h, 2 h and 3 h blood glucose levels, with normal values of 5.6 mmol/L, 10.3 mmol/L, 8.6 mmol/L and 6.7 mmol/L, respectively, two or more of which exceed normal values. According to the NIH, based on the two-step diagnostic method, about 5% of pregnant women in the United States are diagnosed with GDM. The NIH states that under the two-step diagnostic method, about 5 percent of pregnant women in the United States are diagnosed with GDM, while the one-step diagnostic method increases this percentage to 15 percent. It is unclear whether those pregnant women with an “additional” diagnosis of GDM will benefit from it. What is clear, however, is that there is a significant increase in health care costs, with one study showing an increase from $636 million to $2 billion nationwide. In addition, pregnant women diagnosed with GDM experience anxiety, an increased risk of hypoglycemia while undergoing treatment, and an increased chance of cesarean delivery. There is now strong evidence that the two-step diagnostic approach improves pregnancy outcomes, while similar evidence is not available for the one-step diagnostic approach. In response to the NIH statement, the American College of Obstetricians and Gynecologists (ACOG), which has consistently supported the two-step approach, noted that the ACOG recommends that the two-step approach continue to be followed and that the resources needed to perform these tests be considered before changes are made to the diagnostic criteria. However, the American Diabetes Association (ADA) took the opposite approach to the ACOG, with an ADA spokesperson arguing that the evidence for the one-step diagnostic approach comes from the HAPO study, which showed that pregnant women and newborns are at significantly higher risk of poor prognosis even when their blood glucose levels are only mildly elevated.