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Committee on the Reassessment of Definition, Screening, and Diagnostic Criteria for Gestational Diabetes Mellitus

This committee was established in consideration of the need to reassess the basic matters of the definition, screening methods, and diagnostic criteria of gestational diabetes mellitus (GDM). This reassessment should lead to a common understand among physicians of the disease of GDM, grounded in evidence-based medicine (EBM), while due consideration must be paid to consistency with international guidelines.

In November 2005, the Fifth International Workshop-Conference on Gestational Diabetes Mellitus was held in Chicago. At this meeting, the current definition of gestational diabetes mellitus was not changed, and it was agreed that the current diagnostic criteria for GDM is practical to use until the results of the RCT HAPO (hyperglycemia and adverse pregnancy outcome) study come out.

Meanwhile, multi-center studies concerning screening for GDM in Japan are making further advances. The accuracy and cost of various screening methods during the early and middle stages of pregnancy have been analyzed. In these studies, about 80% of GDM was discovered during the first trimester of pregnancy. The results showed that, in the first trimester of pregnancy, casual blood sugar value (cut-off value: 95 mg/dl), and, in the second trimester of pregnancy, the glucose challenge test (cutoff value: 140 mg/dl), are valid screening methods.

Based on the new information detailed above, the research committee prepared a proposal for the definition, diagnostic criteria, and screening methods for GDM. Henceforward, corrections will be made and the final draft will be submitted to the Board of Directors.

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