[Gestational diabetes: the urgent need for a consensus].

About 2% of all pregnant women are affected by gestational diabetes. Unfortunately there is no unanimity in considering the criteria for the definition, classification and screening of these patients. This work tries to sort out the principal elements to be found in the literature that could help to work out a consensus in this field. At the present time, one of the best definitions seems to be "any pregnant women in whom the onset or recognition of diabetes or impaired glucose tolerance occurs during pregnancy". So, gestational diabetes is not synonymous of White's Class A and it is suggested to restrict the White classification to the diabetic women who subsequently become pregnant. The diagnostic test to establish glucose intolerance will be the oral glucose tolerance test with 100 g glucose. Various sets of criteria have been suggested for the interpretation of this test but it is advisable to use normal values established by one of the prospective studies, either by O'Sullivan in the USA or by Pinget in France or by Abell in Australia. As far as screening is concerned, the most sensible, specific and easy strategy appears to estimate, in every pregnant woman, the plasma glucose level one hour after a load of 50 g and to restrict oral glucose tolerance tests to the pregnant women whose results is above 150 mg%.