J Korean Diabetes.  2023 Jun;24(2):55-58. 10.4093/jkd.2023.24.2.55.

The Importance of Early Diagnosis for Gestational Diabetes Mellitus

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea


Recently, there has been an increase in the number of young individuals with obesity, as well as an increase in the number of older pregnant women, resulting in a higher incidence not only of gestational diabetes, but also of diabetes during the first trimester. In addition, there has been an increase in the number of pregnant women with higher-than-normal glucose tolerance that do not meet the diagnostic criteria for diabetes at their first prenatal examination. In such cases, it is important to consider whether it is appropriate to wait until gestational age of 24 weeks to diagnose gestational diabetes via the oral glucose tolerance test or whether early diagnosis and management should be pursued. There is a lack of high-quality research on the appropriate timing and methods for early diagnosis of gestational diabetes. The upcoming results of the ongoing the Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) study will provide an opportunity to evaluate the appropriate timing for gestational diabetes diagnosis.


Diabetes; gestational; Diabetes mellitus; Obesity


  • Fig. 1. Hyperglycemia during pregnancy. The area of dotted lines represents early GDM. HIP, hyperglycemia in pregnancy; DIP, diabetes in pregnancy; GDM, gestational diabetes mellitus.


1.World Health Organization (WHO) Expert Committee on Diabetes Mellitus. Diabetes mellitus: report of a WHO Expert Committee. Geneva: WHO;1965.
2.Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group. Diabetes. 1979. 28:1039–57.
3.Metzger BE., Gabbe SG., Persson B., Buchanan TA., Cat-alano PA., Damm P, et al. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010. 33:676–82.
4.Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization guideline. Diabetes Res Clin Pract. 2014. 103:341–63.
5.Cosson E., Bentounes SA., Nachtergaele C., Berkane N., Pin-to S., Sal M, et al. Prognosis associated with sub-types of hyperglycaemia in pregnancy. J Clin Med. 2021. 10:3904.
6.Wong T., Ross GP., Jalaludin BB., Flack JR. The clinical significance of overt diabetes in pregnancy. Diabet Med. 2013. 30:468–74. Erratum in: Diabet Med 2013;30: 887.
7.Bartha JL., Martinez-Del-Fresno P., Comino-Delgado R. Gestational diabetes mellitus diagnosed during early pregnancy. Am J Obstet Gynecol. 2000. 182:346–50.
8.Bartha JL., Martinez-Del-Fresno P., Comino-Delgado R. Early diagnosis of gestational diabetes mellitus and pre-vention of diabetes-related complications. Eur J Obstet Gynecol Reprod Biol. 2003. 109:41–4.
9.Sweeting AN., Ross GP., Hyett J., Molyneaux L., Constantino M., Harding AJ, et al. Gestational diabetes mellitus in early pregnancy: evidence for poor pregnancy outcomes despite treatment. Diabetes Care. 2016. 39:75–81.
10.Sovio U., Murphy HR., Smith GC. Accelerated fetal growth prior to diagnosis of gestational diabetes mellitus: a pro-spective cohort study of nulliparous women. Diabetes Care. 2016. 39:982–7.
11.Venkataraman H., Ram U., Craik S., Arungunasekaran A., Seshadri S., Saravanan P. Increased fetal adiposity prior to diagnosis of gestational diabetes in South Asians: more evidence for the ‘thin-fat’ baby. Diabetologia. 2017. 60:399–405.
12.Riskin-Mashiah S., Damti A., Younes G., Auslander R. Normal fasting plasma glucose levels during pregnancy: a hospital-based study. J Perinat Med. 2011. 39:209–11.
13.Immanuel J., Simmons D. Screening and treatment for ear-ly-onset gestational diabetes mellitus: a systematic review and meta-analysis. Curr Diab Rep. 2017. 17:115.
14.Bozkurt L., Göbl CS., Pfligl L., Leitner K., Bancher-Todesca D., Luger A, et al. Pathophysiological characteristics and effects of obesity in women with early and late manifestation of gestational diabetes diagnosed by the International Association of Diabetes and Pregnancy Study Groups criteria. J Clin Endocrinol Metab. 2015. 100:1113–20.
15.Harper LM., Jauk V., Longo S., Biggio JR., Szychowski JM., Tita AT. Early gestational diabetes screening in obese women: a randomized controlled trial. Am J Obstet Gynecol. 2020. 222:495.e1–8.
16.Simmons D., Hague WM., Teede HJ., Cheung NW., Hibbert EJ., Nolan CJ, et al. Hyperglycaemia in early pregnancy: the treatment of booking gestational diabetes mellitus (TOBOGM) study. A randomised controlled trial. Med J Aust. 2018. 209:405–6.
Full Text Links
  • JKD
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr