We thank Drs Kalra et al for expressing their concerns regarding changing the diagnostic criteria for gestational diabetes mellitus (GDM). We fully recognize that physicians in countries with a very high disease burden would want to pursue every opportunity to provide care at the earliest point possible in efforts to reduce long-term effects of diabetes. Therefore, we can appreciate the authors' desire to encourage universal change in the GDM diagnostic threshold, thus allowing practitioners to intervene in the potential disease course at a time when otherwise no steps to prevent progression to diabetes would be taken. However, our article addressed whether adopting the International Association of Diabetes and Pregnancy Study Groups' recommended criteria would improve outcomes in women in the United States. We and others are not convinced that change is better than the current approach.
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