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The blood glucose diagnostic thresholds for gestational diabetes remain controversial. In the UK the National Institute for Health and Care Excellence (NICE) has published updated guidance for its diagnosis based upon a health economic analysis using local population datasets, and treatment effects estimated from published intervention trials. The resulting thresholds differ from those of the WHO, and in this issue of Diabetologia (DOI: 10.1007/s00125-015-3647-z ), Meek et al have compared the impact of the two sets of diagnostic criteria on 25,543 pregnant women cared for at their unit in Cambridge, UK. This commentary discusses their paper and its implications for pregnant women in the UK.

Diagnosis of gestational diabetes, defining the net, refining the catch