A pregnant woman at 28 weeks undergoes a 75 g oral glucose tolerance test (OGTT). Her fasting plasma glucose is 94 mg/dL, 1-hour value is 188 mg/dL, and 2-hour value is 150 mg/dL. Using the IADPSG/WHO 2013 criteria, the diagnosis is:

• A Normal glucose tolerance — all values within normal limits
• B Gestational diabetes mellitus based on the fasting glucose alone ✓
• C Gestational diabetes mellitus based on the 1-hour glucose alone
• D Gestational diabetes mellitus; two of three OGTT values must be abnormal

Explanation

IADPSG/WHO 2013 criteria for GDM (75 g OGTT): fasting ≥92 mg/dL, 1-hour ≥180 mg/dL, 2-hour ≥153 mg/dL — any ONE abnormal value is diagnostic. In this case, fasting glucose of 94 mg/dL (≥92) alone meets the GDM criterion, even though the 1-hour (188 mg/dL meets ≥180) also exceeds the threshold and the 2-hour is normal. A single abnormal value is sufficient for diagnosis under IADPSG criteria, unlike the older Carpenter-Coustan system requiring two abnormal values.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.