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Reassessment of the new diagnostic thresholds for gestational diabetes mellitus: an opportunity for improvement

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To the Editor: A recent article by d’Emden focused on concerns about the new diagnostic criteria for gestational diabetes mellitus (GDM).1 In his article, he states that “women may be charged higher life insurance premiums because of a prior diagnosis of GDM”.1 A similar unreferenced concern was also expressed in 2013.2

We specifically examined this aspect in an Australian context.3 Twelve life insurance companies, responsible for more than an estimated 90% of the Australian retail life insurance market, were surveyed with a request from a hypothetical applicant. This applicant was a 40-year-old woman, with no current health problems, who had an episode of GDM 10 years earlier and a subsequent normal result on an oral glucose tolerance test. Ten of the twelve companies (83%) responded, and were unanimous that no additional insurance premium would be required.

The new Australasian Diabetes in Pregnancy Society criteria are likely to result in an increased prevalence of GDM.4 Logically, this may lead to an increase in the cost of initial treatment, but this cost may effectively be recovered by better obstetric outcomes.5 Local data are required.

It is inevitable that any change…

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