Which of the following is the recommended fasting blood glucose threshold for diagnosis of gestational diabetes mellitus using the 75-g oral glucose tolerance test (OGTT) according to WHO criteria?

Explanation

## WHO Diagnostic Criteria for Gestational Diabetes (2013) **Key Point:** The WHO revised criteria (2013) use a single 75-g OGTT with three timepoints and lower thresholds than previous definitions. ### Diagnostic Thresholds (75-g OGTT) | Timepoint | WHO Threshold (mg/dL) | WHO Threshold (mmol/L) | | --- | --- | --- | | **Fasting** | ≥ 92 | ≥ 5.1 | | **1 hour** | ≥ 180 | ≥ 10.0 | | **2 hours** | ≥ 153 | ≥ 8.5 | **High-Yield:** A diagnosis of GDM is made if **ANY ONE** of these three values is met or exceeded. This is a departure from earlier criteria that required 2 abnormal values. **Clinical Pearl:** The fasting threshold of ≥ 92 mg/dL is notably lower than the non-pregnant fasting glucose diagnostic criterion for diabetes (≥ 126 mg/dL), reflecting the increased insulin sensitivity demands of pregnancy and the need for earlier intervention to prevent adverse perinatal outcomes. ### Why This Matters - Lower thresholds increase detection of mild hyperglycemia in pregnancy - Early identification allows timely lifestyle and pharmacologic intervention - Reduces risk of macrosomia, neonatal hypoglycemia, and maternal complications