Dr. de Valk and I have reviewed the published arguments for and against changing the diagnostic criteria for GDM now, and we have other concerns, including the timing and poor reproducibility of the OGTT, the reliance on large for gestational age as an endpoint for setting diagnostic criteria, and the increase in use of oral antidiabetic drugs that could result from a vast increase in GDM.
Overall, we agree with the National Institutes of Health panel that real evidence for change is lacking, and that there is a lot to be done before we significantly expand GDM.
Dr. Visser is professor of obstetrics and gynecology at University Medical Center in Utrecht, the Netherlands.
Based on presentations made at the annual meeting of the Diabetes in Pregnancy Study Group of North America, Washington. Both Dr. Coustan and Dr. Visser reported that they had no conflicts of interest to disclose.