To the editor:

I read with interest the article by Eoin Noctor et al. [1] in which 25 % of 265 women with previous GDM by IADPSG criteria met metabolic syndrome criteria approximately 3 years after their index pregnancies compared to 7 % of 378 women who had normal glucose tolerance in pregnancy. There is currently considerable controversy regarding the use of IADPSG criteria for gestational diabetes versus the 1999 WHO criteria, as recently advocated by NICE (National Institute for Health and Care Excellence) in the UK (http://www.nice.org.uk/guidance/ng3/chapter/1-recommendations, accessed 4 May 15). I presume that there were, among the 265 women with previous gestational diabetes, a number whose 2-h OGTT plasma glucose met the WHO 1999 criteria but not the IADPSG criteria, as well as some who met the IADPSG criteria but not the WHO 1999 criteria, and another group who met both criteria. It would be informative to this controversy if the authors were able to subdivide their data to determine which criteria identify individuals at greater risk for metabolic syndrome in the future.

Sincerely,

Donald R. Coustan, MD