Gestational diabetes mellitus (GDM) has become increasingly prevalent worldwide. Class A1GDM refers to diet-controlled GDM. Class A2GDM refers to the clinical scenario where medications are required. The following synopsis highlights key practice points from various professional organizations.
The ACOG update is based on ADA criteria | Consider early screening in pregnancy if patient is overweight with BMI of ≥25 kg/m3 (23 in Asian Americans), and one or more of the following
Note: The ADA (2025) uses 130/80 as the BP threshold for hypertension diagnosis
The argument against the one-step approach has been that it increases the incidence of GDM significantly, without proven improvement in maternal and/or perinatal outcomes
Our meta-analysis of RCTs, however, provides level-1 evidence that the one-step approach significantly improves perinatal outcomes
In particular, we found a 54% reduction in the risk of LGA
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