Odds, risks and appropriate diagnosis of gestational diabetes: comment

In my opinion, McIntyre and colleagues have misunderstood the primary point I raised in my earlier article in the Journal.1 My concern was not the increased number of women diagnosed with gestational diabetes mellitus (GDM), but the accuracy of the diagnostic thresholds. Although I suggested that many women in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study with one elevated blood glucose level may not be at risk, I also stated that additional women with two or more blood glucose levels marginally below the new thresholds will be at risk. The authors' comment that an increased odds ratio has the same effect confirms that they misunderstood my concern.