The HAPO (Hyperglycemia and Adverse Pregnancy Outcomes) study established thresholds for gestational diabetes diagnosis. What glucose thresholds (fasting/1-h/2-h) does IADPSG (WHO 2013) use for diagnosing GDM on a 75 g OGTT?

• A Fasting ≥5.3 mmol/L (95 mg/dL), 1-h ≥10.6 mmol/L (190 mg/dL), 2-h ≥9.2 mmol/L (165 mg/dL) — two or more values
• B Fasting ≥7.0 mmol/L (126 mg/dL) alone OR 2-h ≥11.1 mmol/L (200 mg/dL) — standard diabetes criteria applied in pregnancy
• C Fasting ≥5.1 mmol/L (92 mg/dL), 1-h ≥10.0 mmol/L (180 mg/dL), 2-h ≥8.5 mmol/L (153 mg/dL) — any ONE value ✓
• D Fasting ≥5.0 mmol/L (90 mg/dL), 1-h ≥9.4 mmol/L (170 mg/dL), 2-h ≥8.0 mmol/L (145 mg/dL) — any ONE value

Explanation

The IADPSG criteria (adopted by WHO 2013), derived from the HAPO study, use a 75 g OGTT with diagnosis of GDM if ANY one value meets or exceeds: fasting ≥5.1 mmol/L (92 mg/dL), 1-hour ≥10.0 mmol/L (180 mg/dL), or 2-hour ≥8.5 mmol/L (153 mg/dL). These thresholds correspond to 1.75× the mean OGTT value associated with adverse outcomes. Unlike Carpenter-Coustan criteria (which require 2 abnormal values), IADPSG requires only ONE value to be met.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.