It’s time to widen the capture of gestational diabetes in the UK

Loder’s outlining of less-than-ideal contemporary efforts to tackle public health1 are laudable.1The systematic review and meta-analysis by Xie and colleagues2 show the negative long term effects on maternal and child health associated with gestational diabetes, based on International Association of Diabetes and Pregnancy Study Groups (IADPSG) oral glucose tolerance test thresholds (fasting: 5.1 mmol/l, 1‐h: 10.0 mmol/l, 2‐h: 8.5 mmol/l).3 These thresholds were endorsed by the World Health Organization and have been adopted by most professional organisations around the world, including in Scotland. In other parts of the UK, however, less sensitive National Institute of Clinical Excellence (NICE) thresholds (fasting: 5.6 mmol/l, 2‐h: 7.8 mmol/l) are in place.4The net effect is that fewer women with significant risk factors, such as obesity, are offered an opportunity to make the lifestyle changes highlighted by Yang and colleagues.5 This is regrettable, especially as NICE diagnostic thresholds have also been demonstrated to disproportionately under-diagnose…
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