A call to reconsider the new diagnostic criteria for gestational diabetes mellitus

We read the article by Nethery and colleagues1 with great interest, having noted a similar dramatic increase in the incidence of gestational diabetes in Australia, coincident with widespread adoption of the 1-step test using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Although the authors did not examine clinical or health system effects from the change in diagnostic practice, they noted that, “Health system costs may increase, with a need for more endocrinologists, diabetes nurse educators or dietitians; additional sonograms; or more intensive monitoring during labour, delivery and the postpartum period.”