The HAPO study (Hyperglycemia and Adverse Pregnancy Outcomes, 2008) led to the IADPSG 2010 diagnostic criteria for gestational diabetes mellitus (GDM). The IADPSG criteria use a single-step 75g OGTT at 24–28 weeks. Which of the following correctly states the diagnostic thresholds?

• A Fasting ≥100 mg/dL; 1-hour ≥180 mg/dL; 2-hour ≥140 mg/dL — any ONE value meets diagnosis
• B Fasting ≥92 mg/dL; 1-hour ≥180 mg/dL; 2-hour ≥153 mg/dL — all THREE values must be exceeded
• C Fasting ≥110 mg/dL; 2-hour ≥140 mg/dL — both values must exceed threshold
• D Fasting ≥92 mg/dL; 1-hour ≥180 mg/dL; 2-hour ≥153 mg/dL — any ONE value meets diagnosis ✓

Explanation

The IADPSG 2010 criteria (adopted by WHO 2013 and FOGSI/DIPSI in India for universal screening) use one or more of the following thresholds on a 75g 2-hour OGTT at 24–28 weeks: fasting plasma glucose ≥92 mg/dL (5.1 mmol/L); 1-hour glucose ≥180 mg/dL (10.0 mmol/L); 2-hour glucose ≥153 mg/dL (8.5 mmol/L). Meeting ANY ONE value is sufficient for GDM diagnosis. This single-step universal approach replaced the two-step Carpenter-Coustan criteria used in North America (50g screen followed by 100g OGTT).

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.