Gestational Diabetes Classification | Medical Algorithm

White developed a classification for women with diabetes mellitus during pregnancy that can help identify those at increased risk for complications.

Criterion	Class
gestational diabetes, insulin not required	A1
gestational diabetes, insulin required	A2
age of onset >= 20 years (maturity onset diabetes)	B1
duration < 10 years, no vascular lesions	B2
age of onset 10-19 years of age	C1
duration 10-19 years, no vascular lesions	C2
age of onset < 10 years of age	D1
duration >= 20 years	D2
benign retinopathy	D3
calcified arteries of legs	D4
calcified arteries of pelvis (no longer sought)	E
nephropathy	F
many failures	G
cardiopathy	H
proliferating retinopathy	R
renal transplant	T

from White, Tables II and III, page 229; Evans page 123

where:

• Table II shows Class B to be composed of B1 and B2 criterion. I separated these out to match the handling of Classes C and D.

• White uses <10, 10-19, and "over 20" to specify age of onset and duration. Evans et al use <10, 10-20, and > 20.

• In Evans et al, type A is termed gestational diabetes, with A1 not requiring insulin and A2 requiring insulin.

• In White's paper, Class A is divided according to the subtypes of chemical diabetes of Tyson and Felig:

Criterion (Tyson and Felig)	Class
chemical diabetes with glycosuria, positive glucose tolerance test and insulinopenia	A1
chemical diabetes with glycosuria, positive glucose tolerance test and hyperinsulinism	A2
chemical diabetes with obesity, positive glucose tolerance test and insulinopenia	A3

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Classification for Diabetes During Pregnancy