To be clear, all experts agree that screening pregnant women for GDM is an important part of obstetrical care. Indeed, the United States Preventative Services Task Force has recommended screening all pregnant women for GDM. The controversy centers on how to best screen for the condition. Several studies have now been conducted that evaluate outcomes when GDM is identified via the one-step or two-step approach. Perhaps not surprisingly, the conclusions of these various studies are not in agreement with each other. As expected, all studies report an increased number of women diagnosed with GDM using the one-step test. However, the outcomes of these pregnancies are reported as improved in some studies, while others describe no improvements compared to GDM cases diagnosed by the two-step test. The debate, therefore, continues, as it remains unclear if the increased number of women identified as having GDM by the one-step approach have truly benefited from treatments for GDM or if they have been subjected to unnecessary (and potentially harmful) interventions. A uniform approach to identifying GDM is needed, but more data and more studies will be necessary before a consensus opinion on one that produces the greatest benefits with the least risks will be achieved.