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New IADPSG recommendations: impact on care for gestational diabetes

Annunziata Lapolla, Nino Cristiano Chilelli & Maria Grazia Dalfra

If gestational diabetes mellitus (GDM) is not recognized and treated, it has a negative impact on maternal and fetal health. No general consensus on how best to screen for and diagnose this disease has been established to date. The Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study and two randomized trials on the treatment of mild GDM have confirmed the close relationship between maternal glycemia and perinatal outcome. In the light of these findings, new recommendations have recently been formulated by the International Association of Diabetes and Pregnancy Study Groups (IADPSG), also concerning the diagnosis of overt diabetes early in pregnancy and routine screening for GDM at 24 gestational weeks with a 75 g oral glucose tolerance test, considering even only one higher than normal value sufficient for a diagnosis of GDM. Here we discuss the possible impact of these new recommendations on the treatment of GDM.