and Pregnancy Study Groups (IADPSG) in 2010 [9] and the
American Diabetes Association in 2011 [10]. However, with
the OGTT one needs to fast at least 8 hours, which is difficult
to administer in Taiwan because many pregnant women are
only able or willing to visit the outpatient department in the
afternoon or evening (unique worldwide).
Furthermore, the committee opinion by the American College
of Obstetricians and Gynecologists showed that there is no
evidence that the identification and treatment of women based
on the new IADPSG recommendations will lead to clinically
significant improvements in maternal and neonatal outcomes
and also lead to a significant increase in healthcare costs. The
diagnosis of GDM should be based on a two-step approach [50-
g glucose challenge test (GCT) and a 100-g OGTT] [11].
Thus, the diagnostic criteria for GDM are still a matter of
discussion owing to the lack of consensus and racial and social
specifics in various states and the requirement for fasting