Use of lower glycaemic criteria for the diagnosis of gestational diabetes does not alter the risk for large-for-gestational-age infants, according to a study published in the 18 August issue of the New England Journal of Medicine.

Caroline A Crowther, MD, from the University of Auckland in New Zealand, and colleagues randomly assigned 4061 women at 24 to 32 weeks of gestation to be evaluated for gestational diabetes (GDM) with the use of lower or higher glycaemic criteria for diagnosis. 

The lower glycaemic criterion was a fasting plasma glucose level of ≥92mg/dL (≥5.1mmol/L), a one-hour level of ≥180mg/dL (≥10mmol/L), or a two-hour level of ≥153mg/dL (≥8.5mmol/L), while a fasting plasma glucose level of ≥99mg/dL (≥5.5mmol/L) or a two-hour level of ≥162mg/dL (≥9.0mmol/L) was the higher glycaemic criterion.

The researchers found that GMD was diagnosed in 15.3% of 2022 women in the lower-glycaemic-criteria group and in 6.1% of 2039 women in the higher-glycaemic-criteria group.