Gestational diabetes mellitus

Gestational diabetes mellitus (GDM)

According to the American Diabetes Association (ADA), hyperglycemia first detected during pregnancy after the first trimester should be classified as GDM.[1]
It is usually recognized at 24-28 weeks of gestation on the basis of abnormal glucose tolerance testing.[1]

Preexisting (overt) type 2 diabetes

Because of the number of pregnant women with undiagnosed type 2 diabetes, it is recommended that clinicians test women with risk factors for type 2 diabetes preconception or at their initial prenatal visit, using standard diagnostic criteria.[1] Universal screening for undiagnosed diabetes of all women preconception or at the first prenatal visit is also a reasonable strategy to consider, especially in populations with increased risk factors for type 2 diabetes.[1]
According to the ADA, women with confirmed fasting glucose levels of ≥126 mg/dL (≥7.0 mmol/L) or random glucose levels ≥200 mg/dL (≥11.1 mmol/L) in the first trimester receive a diagnosis of preexisting rather than GDM.[1][49]

Abnormal glucose metabolism

Women with glucose levels that, although not meeting criteria for diabetes, are nevertheless too high to be considered normal are defined as having impaired fasting glucose (fasting plasma glucose levels of 100-125 mg/dL [5.6 mmol/L to 6.9 mmol/L]), or impaired glucose tolerance (2-hour oral glucose tolerance test values of 140-199 mg/dL [7.8 mmol/L to 11.0 mmol/L]).[1]
The ADA recognizes early abnormal glucose metabolism, defined by a threshold fasting glucose level of 110-125 mg/dL (6.1 mmol/L) or an HbA1c of 5.9% to 6.4% (41-47 mmol/mol), as a risk factor for GDM later in pregnancy.[1]

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