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Bruce L. Ring, MD
Brockton, Mass

JAMA. 1993;270(3):324.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Magee et al¹ recommend wider use of the modified criteria of Carpenter and Coustan² for the diagnosis and treatment of gestational diabetes mellitus (GDM). Abnormalities of carbohydrate metabolism are likely a continuum, however, requiring treatment of some patients with lesser degrees of intolerance at the expense of others not requiring therapy. Langer et al³ recommend therapy for those with one abnormal value on the 3-hour glucose tolerance test (GTT) using the National Diabetes Data Group (NDDG) values, since this group had an adverse perinatal outcome if left untreated. In comparison with those with a normal 1-hour glucose screen, Leiken et al⁴ noted a significantly higher frequency of macrosomia in those with an abnormal 1-hour glucose screening test though their 3-hour tests were "normal" by the modified criteria. Included in this normal group and not analyzed separately, however, were 16.8% of the study patients . . . [Full Text PDF of this Article]

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