Gestational Diabetes Mellitus: New Thinking on Diagnostic Criteria

Currently, there is a lack of standardized diagnostic criteria for gestational diabetes mellitus (GDM), making it a subject of ongoing debate. The optimal diagnostic method and screening strategy for GDM remain contentious. In this review, we summarize the criteria and methods for diagnosing GDM, and perform a comparison between universal and selective screening strategies. Therefore, this review aims to highlight the following: (1) The most widely adopted criteria for GDM are those established by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). (2) Evidence from cohort studies suggests that the one-step diagnostic method is associated with improved pregnancy outcomes and appears more cost-effective compared to the two-step method. (3) Universal screening is more cost-effective than selective screening, which may overlook a significant number of women with GDM. Additionally, various methods have been proposed for early pregnancy screening (before 14 weeks). Finally, an outlook is presented for the diagnosis of GDM, emphasizing the importance of large-scale randomized controlled trials (RCTs) to provide stronger evidence for future support.