Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) 2014 - fact, frustration and future needs

The concept of gestational diabetes mellitus (GDM) or hyperglycaemia in pregnancy has long been recognised but is still the subject of much controversy.1 Many different screening protocols and clinical guidelines exist, but no international consensus, and even within countries there is considerable confusion as to what constitutes best practice. Two randomized clinical trials (RCTs) however recently confirmed that treatment of mild hyperglycaemia (largely lifestyle alteration) is effective for a variety of maternal and fetal endpoints.2,3 This leaves the question of how best to define hyperglycaemia in pregnancy, and how to identify it during the pregnancy.