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Back| Class A: Diabetes detected during pregnancy. |
| Class B: Overt diabetes, onset after age 20, duration less than 10 years, without vascular complications. |
| Class C: Onset between ages 10 and 19, or duration of 10 to 19 years, without vascular complications. |
| Class D: Onset before age 10, or duration ≥ 20 years, or with simple retinopathy. |
| Class F: Diabetic nephropathy. |
| Class R: Proliferative retinopathy. |
| Class H: Diabetic heart disease. |
Description
Additionally, gestational diabetes (GDM) is further classified into A1 and A2 levels based on maternal blood glucose control:
Level A1: Fasting blood glucose (FBG) < 5.8 mmol/L, controlled by diet, with postprandial blood glucose < 6.7 mmol/L. A1 GDM has fewer maternal and fetal complications, and postpartum glucose metabolism abnormalities can often return to normal.
Level A2: Controlled by diet, FBG > 5.8 mmol/L, postprandial blood glucose ≥ 6.7 mmol/L, requiring insulin to control blood glucose during pregnancy. A2 GDM has more maternal and fetal complications and an increased incidence of fetal malformations.
The current classification is based on the 1994 recommendations of the American College of Obstetricians and Gynecologists (ACOG), where classes B-H follow the commonly used White classification. Staging is based on the age of onset of diabetes, duration, presence of vascular complications, and organ involvement, which helps estimate the severity and prognosis of the condition.
