gestational diabetes was similar (3.6%–3.7%) in each of
the 3 groups. Assuming that the prevalence of GDM by
the new ADA criteria would be in the 16% range, the
cost per case of GDM diagnosed would presumably fall
from Can$3010 to Can$677, and in that sense the ADA
1-step approach would be considerably more costeffective than either 2-step approach. A decision analysis model (74) was used to compared no screening
with the current ACOG approach (13) and the
IADPSG/ADA approach (1). Compared to no screening, the IADPSG/ADA strategy was equally as costeffective as the current ACOG strategy only if treatment included postdelivery care, which reduces the
incidence of subsequent diabetes. It is to be expected
that more information about public health implications will become available if and when the new criteria
are more widely adopted.
Regardless of the criteria used, gestational diabetes
is increasing in prevalence around the world in parallel
with the increasing prevalence of obesity and type 2
diabetes. All of these trends will no doubt stress the
healthcare systems both in the US and abroad. Hopefully, more efficient and more scientifically based approaches to diagnosis and treatment will evolve to keep
up with demands. Ultimately, prevention must be the
goal.
Author Contributions:Allauthorsconfirmedtheyhavecontributedto
the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design,
acquisition of data, or analysis and interpretation of data; (b) drafting
or revising the article for intellectual content; and (c) final approval of
the published article.
Authors’ Disclosures or Potential Conflicts of Interest: No authors
declared any potential conflicts of interest.