1-Hour postprandial glucose target of < 120 mg/dL is superior to < 140 mg/dL in the treatment for gestational diabetes mellitus in relation to pregnancy outcomes: A retrospective study

Maternal hyperglycemia during pregnancy is associated with short- and long-term adverse effects affecting both mothers and the offspring. Despite behavioral and pharmacological treatment, the rate of maternal and neonatal complications in pregnancies complicated with gestational diabetes mellitus (GDM) is still higher than in general population [1, 2]. Data from the Hyperglycemia and Adverse Pregnancy Outcome Study (HAPO) that was first published in 2008 showed a continuous positive correlation between glycemia on the 75-g oral glucose tolerance test (OGTT) and the rate of large for gestational age infants (LGA), neonatal hypoglycemia, cord blood C-peptide concentration > 90th percentile, and cesarean section in a cohort of approximately 25,000 pregnant women from different populations [3]. On this basis, the new diagnostic criteria for GDM were proposed and then incorporated into the most recommendations and standards, including these published by the World Health Organization (WHO). Still, there is no universally accepted consensus on glycemic goals in the treatment for GDM because data on the effect of different glycemic targets on pregnancy outcomes in GDM are limited. Most scientific societies suggest the thresholds for glucose concentrations of 95 mg/dL at fasting and 140 mg/dL at 1-h postprandial (strength-of-recommendation grade B) [4]. In 2017, the Polish Diabetes Association (PDA) raised the 1-h postprandial glucose (1-h PPG) threshold from < 120 mg/dL to < 140 mg/dL [5]. This change prompted us to compare the obstetric results of women with GDM in two time intervals: treated using the previous (1-h PPG < 120 mg/dL) and present (1-h PPG < 140 mg/dL), less stringent, recommendations.