To the Editor: McIntyre and Oats promote the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for gestational diabetes mellitus (GDM) as being well reasoned.1 Derived from observational data and mathematical modelling in an attempt to provide a worldwide definition and to improve outcomes, these criteria will significantly increase the number of women diagnosed with GDM2 in health care systems that have limited resources. To help achieve cost savings, clinicians should be leaders in preventing interventions in circumstances where effectiveness or harm is unknown.3
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- 1. McIntyre HD, Oats JJN. Gestational diabetes needs to be managed. Med J Aust 2013; 198: 78-79. <MJA full text>
- 2. Moses RG, Morris GJ, Petocz P, et al. The impact of potential new diagnostic criteria on the prevalence of gestational diabetes mellitus in Australia. Med J Aust 2011; 194: 338-340. <MJA full text>
- 3. Scott I. Only clinician leadership will save healthcare systems from insolvency. Mediscussion 2013; 6: 10-11.
- 4. Crowther CA, Hiller JE, Moss JR, et al; Australian Carbohydrate Intolerance Study in Pregnant Women Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005; 352: 2477-2486.
- 5. Landon MB, Spong CV, Thom E, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network. A multicenter, randomised trial of treatment for mild gestational diabetes. N Engl J Med 2009; 361: 1339-1348.
- 6. National Institutes of Health Consensus Development Conference: Diagnosing Gestational Diabetes Mellitus Conference [draft statement]. March 4–6, 2013. http://prevention. nih.gov/cdp/conferences/2013/gdm/files/DraftStatement.pdf (accessed May 2013).
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