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Controversy grows over redefinition of gestational diabetes

Ray N Moynihan
Med J Aust 2012; 197 (4): . || doi: 10.5694/mja12.11155
Published online: 20 August 2012

Ray Moynihan reports on the bitter battle over blood sugar levels and pregnancy

One of the freshest fights over the definition of disease is happening with gestational diabetes. A recent redefinition more than doubles the patient pool and labels up to one in five pregnant women as unwell.1 The new criteria arose at a conference in California in 2008, were published in 2010, and are now being endorsed around the world, including by the Australasian Diabetes in Pregnancy Society. Yet the expanded definition is the subject of sustained criticism and will be further scrutinised at a United States National Institutes of Health (NIH) consensus development conference, by an adjudicating panel free of members with financial or reputational conflicts of interest, to be held in Maryland in October this year.


  • 1 Bond University, Gold Coast, QLD.
  • 2 University of Newcastle, Newcastle, NSW.


Correspondence: raymoynihan@bond.edu.au

Competing interests:

I receive a postgraduate scholarship for my PhD, which involves research into overdiagnosis.

  • 1. Metzger BE, Gabbe SG, Persson B, et al; International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33: 676-682.
  • 2. Ryan EA. Diagnosing gestational diabetes. Diabetologia 2011; 54: 480-486.
  • 3. Cundy T. Proposed new diagnostic criteria for gestational diabetes — a pause for thought? Diabet Med 2012; 29: 176-180.
  • 4. Ryan E. Diagnostic criteria for gestational diabetes: Who decides? CMAJ 2012. doi: 10.1503/cmaj.120682.
  • 5. Moses RG, Morris GJ, Petocz P, et al. The impact of potential new diagnostic criteria on the prevalence of gestational diabetes mellitus in Australia. Med J Aust 2011; 194: 338-340. <MJA full text>
  • 6. Werner EF, Pettker CM, Zuckerwise L, et al. Screening for gestational diabetes mellitus: are the criteria proposed by the International Association of the Diabetes and Pregnancy Study Groups cost-effective? Diabetes Care 2012; 35: 529-535.
  • 7. Jarrett RJ. Gestational diabetes: a non-entity? BMJ 1993; 306: 37-38.

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