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Correction

Guidelines for the management of gestational diabetes mellitus revisited

David S Simmons, Barry N J Walters, Peter Wein and N Wah Cheung
MJA 2002 177 (5): 279

Re the letter "Guidelines for the management of gestational diabetes mellitus revisited", by David S Simmons, Barry N J Walters, Peter Wein and N Wah Cheung, on behalf of the Australasian Diabetes in Pregnancy Society, published in the 1 April issue (Med J Aust 2002; 176: 352), in which the American College of Obstetricians and Gynecologists criterion for diagnosing gestational diabetes mellitus of a 1-hour fasting plasma glucose level of ≥ 10.0 mmol/L was mistakenly placed in the adjacent Australasian Diabetes in Pregnancy Society column. The entire corrected table is reprinted below.

Differences between management guidelines for gestational diabetes mellitus (GDM) from the Australasian Diabetes in Pregnancy Society (ADIPS, 1998) and the American College of Obstetricians and Gynecologists (ACOG, 2001)

ADIPS

ACOG


Universal versus selective screening by blood test

Universal unless low GDM incidence or resources limited

No recommendation. States that "many physicians elect to screen all pregnant patients as a practical matter"

Differences in definition of low risk for GDM

Age < 30 years, obesity, family history of diabetes

Age < 25 years, body mass index < 25 kg/m2. No known diabetes in first-degree relative

Oral glucose tolerance test used

75 g, 2-hour, 2-point blood sampling

100 g, 3-hour, 4-point blood sampling

Criteria for diagnosis of GDM

Plasma glucose level: Fasting, ≥ 5.5 mmol/L and/or 2-hour, ≥ 8.0 mmol/L

Plasma glucose level: Fasting, ≥ 5.3 mmol/L; 1-hour, ≥ 10.0 mmol/L; 2-hour, ≥ 8.6 mmol/L; 3-hour, ≥ 7.8 mmol/L (2 or more time points need to elevated)

Insulin therapy commenced after medical–nutrition therapy

Plasma glucose level: Fasting, ≥ 5.5 mmol/L and/or 1-hour postprandial, ≥ 8.0 mmol/L and/or 2-hour postprandial, ≥7.0 mmol/L

Plasma glucose level: Fasting, ≥ 5.3 mmol/L and/or 1-hour postprandial, ≥ 7.2–7.8 mmol/L and/or 2-hour postprandial, ≥ 6.7 mmol/L

(Received 26 Jun 2002, accepted 26 Jun 2002)

University of Melbourne, Shepparton, VIC.

David S Simmons, Professor of Rural Health.

University of Western Australia, Department of Obstetrics and Gynaecology, King Edward Memorial Hospital, Subiaco, WA.

Barry N J Walters, Associate Professor (Clinical).

Diabetes Unit, Royal Women's Hospital, Carlton, VIC.

Peter Wein, Obstetrician.

Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW.

N Wah Cheung, Specialist.

Correspondence: Professor David S Simmons, University of Melbourne, PO Box 6500, Shepparton, VIC 3632. dsimmonsATunimelb.edu.au

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