Lower versus Higher Glycemic Criteria for Diagnosis of Gestational Diabetes

This randomized trial compared lower and higher glycemic criteria for diagnosing gestational diabetes (GDM) in 4,061 women at 24–32 weeks’ gestation. The lower criteria diagnosed more women with GDM (15.3% vs. 6.1%), but no significant difference was found in the primary outcome of large for gestational age infants (8.8% vs. 8.9%). The lower criteria group had higher rates of labor induction, pharmacologic treatment, and neonatal hypoglycemia. However, a subgroup analysis showed benefits for treated women with milder hyperglycemia, including fewer large for gestational age infants and lower preeclampsia risk.

This randomized trial compared lower and higher glycemic criteria for diagnosing gestational diabetes (GDM) in 4,061 women at 24–32 weeks’ gestation. The lower criteria diagnosed more women with GDM (15.3% vs. 6.1%), but no significant difference was found in the primary outcome of large for gestational age infants (8.8% vs. 8.9%). The lower criteria group had higher rates of labor induction, pharmacologic treatment, and neonatal hypoglycemia. However, a subgroup analysis showed benefits for treated women with milder hyperglycemia, including fewer large for gestational age infants and lower preeclampsia risk.