The post-HAPO situation with gestational diabetes: the bright and dark sides

Aim: In 2010, in light of the data coming from the HAPO study, the International Association of Diabetes and Pregnancy Study Groups (IADPSG) proposed a new detection strategy and diagnostic criteria for gestational diabetes based on a one-step approach with a 75 g OGTT. This review analyzes and discusses the bright and dark sides of their application. Methods: The assessment of these recommendations by the international organizations involved in the care of gestational diabetes and a series of observational, retrospective and prospective studies that have been published since 2010 regarding the use of the IADPSG recommendations have been evaluated. Results: The different international associations involved in the care of pregnancy and of pregnancy complicated by diabetes have not taken an univocal position some of which have accepted them, while others have criticized them. Then, the actual application of the approach recommended by the IADPSG for detecting and diagnosing GDM varies, even at centers that reportedly accept the new diagnostic criteria. Conclusion: So the challenge lies in making every effort to achieve a global standardization of the strategies for detecting, diagnosing and treating GDM.