The Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study established a linear relationship between maternal glycemia and adverse outcomes. The IADPSG (2010) diagnostic criteria for GDM derived from HAPO use a 75g OGTT with which fasting glucose threshold?

• A ≥5.6 mmol/L (100 mg/dL)
• B ≥5.1 mmol/L (92 mg/dL) ✓
• C ≥6.1 mmol/L (110 mg/dL)
• D ≥7.0 mmol/L (126 mg/dL)

Explanation

IADPSG 2010 criteria (based on HAPO study odds ratios for adverse outcomes) define GDM using the 75g OGTT with three thresholds: fasting ≥92 mg/dL (5.1 mmol/L), 1-hour ≥180 mg/dL (10.0 mmol/L), 2-hour ≥153 mg/dL (8.5 mmol/L)—any ONE value met = GDM diagnosis. This is a one-step approach that replaced the previous two-step (50g challenge + 100g OGTT) approach used in the USA. The IADPSG thresholds correspond to 1.75× the odds of macrosomia, adiposity, or hyperinsulinemia from the HAPO data. This single threshold of 92 mg/dL fasting is notably lower than the previous WHO/Carpenter-Coustan criteria, leading to a 2–3-fold increase in GDM prevalence.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.