Guidelines for the management of gestational diabetes mellitus revisited
Authors: David S Simmons, Barry N J Walters, Peter Wein and N Wah Cheung
Published online: 2 September 2002
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 |
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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" |
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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 |
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Oral glucose tolerance test used |
75 g, 2-hour, 2-point blood sampling |
100 g, 3-hour, 4-point blood sampling |
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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) |
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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 |
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