White developed a classification for women with diabetes mellitus during pregnancy that can help identify those at increased risk for complications.
gestational diabetes, insulin not required
gestational diabetes, insulin required
age of onset >= 20 years (maturity onset diabetes)
duration < 10 years, no vascular lesions
age of onset 10-19 years of age
duration 10-19 years, no vascular lesions
age of onset < 10 years of age
duration >= 20 years
calcified arteries of legs
calcified arteries of pelvis (no longer sought)
from White, Tables II and III, page 229; Evans page 123
• 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)
chemical diabetes with glycosuria, positive glucose tolerance test and insulinopenia
chemical diabetes with glycosuria, positive glucose tolerance test and hyperinsulinism
chemical diabetes with obesity, positive glucose tolerance test and insulinopenia
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Purpose: To classify a pregnant woman with diabetes using the scheme of White.
Specialty: Obstetrics & Gynecology
Objective: risk factors, criteria for diagnosis, differential diagnosis and mimics, red flags, selection