In 1997, the American Diabetes Association (ADA) announced new diagnostic criteria (
1) for diabetes and set the definition of gestational diabetes (GDM). Before 1991, GDM was defined as “a transient abnormality
of glucose tolerance during pregnancy”(
2,3). However, the 1997 definition of GDM by the ADA includes diabetes mellitus diagnosed during pregnancy. This definition ignores
the added risks to the mother and to the fetus when the mother has undiagnosed type 2 diabetes. The epidemic of obesity and
the increased prevalence of type 2 diabetes necessitate a reconsideration of the definition that would separate diabetes and
slightly abnormal carbohydrate metabolism, so called “GDM” to provide a better model of care for type 2 diabetic pregnant
women.
This chapter discusses the current literature that underscores the need for a unique diagnosis for those women with moderate
to severe hyperglycemia and/or other evidence of long-standing diabetes complications. The label of gestational diabetes mellitus
(GDM) is not adequate to identify the urgent need for more intensive surveillance and treatment with the use of multiple insulin
injections in those women for type 2 diabetes in pregnancy.
Key Words Gestational diabetes - pregestational type 2 diabetes - diabetes and pregnancy - screening and diagnosis of diabetes in pregnancy