The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index; none of the 5 sources its claims cite is checked for support yet.
A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022)
Open accessAbstract
Hyperglycemia is one of the most common complications women encounter during pregnancy, and is associated with a higher incidence of short- and long-term health risks for both the mother and offspring. In 2022, the Maternal-Fetal Medicine Committee of the Chinese Society of Obstetrics and Gynecology, Chinese Medicine Association, worked with the Chinese Society of Perinatal Medicine and the Professional Committee of Gestational Diabetes Mellitus of the Chinese Maternal and Child Health Association to update the Guidelines for the diagnosis and management of hyperglycemia in pregnancy in China. The aim was to further standardize the management of hyperglycemia in pregnancy from the aspects of screening, diagnosis, monitoring, treatment, and prevention of gestational diabetes mellitus, and consequently to further improve the health of mother and child.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This article summarizes the 2022 Chinese guidelines for diagnosis and management of hyperglycemia in pregnancy (HIP), covering classification, screening/diagnosis, treatment, monitoring, perinatal care, postpartum follow-up, and prevention. It presents GRADE-rated recommendations, including one-step 75-g OGTT thresholds, glycemic targets, lifestyle/insulin/metformin guidance, and delivery/postpartum follow-up timing.
Key findings
- HIP includes pregestational diabetes mellitus (PGDM), prediabetes (IFG/IGT), and gestational diabetes mellitus (GDM) A1/A2. GDM is diagnosed by a one-step 75-g OGTT at 24–28 weeks using thresholds of fasting 5.1, 1-h 10.0, and 2-h 8.5 mmol/L (Grade A); FPG ≥5.6 mmol/L before 24 weeks is diagnosed as IFG, and PGDM criteria include FPG ≥7.0 mmol/L, random plasma glucose ≥11.1 mmol/L with classic symptoms, or HbA1c ≥6.5%.
- Glycemic targets for GDM/PGDM are FPG <5.3 mmol/L, 1-h postprandial <7.8 mmol/L or 2-h postprandial <6.7 mmol/L, avoiding nocturnal glucose <3.3 mmol/L; HbA1c target is ideally <6%, relaxed to <7% if needed to prevent hypoglycemia.
- Nutrition/lifestyle recommendations include daily calories not below 1600 kcal in early gestation and 1800–2200 kcal in middle/late pregnancy; carbohydrates ≥175 g/day (50%–60% of total calories, 35%–45% for obese women), protein ≥70 g/day, saturated fat ≤7% of calories, fiber >25–30 g/day, and moderate physical activity 30 min/day on at least 5 days/week. One Chinese RCT cited found GDM risk in overweight/obese pregnant women decreased by 45.8% with 3 times/week cycling from early pregnancy.
- Treatment and follow-up recommendations include insulin for PGDM and for GDM when diet/exercise fail; metformin may be used if insulin is unavailable, with efficacy/near-term safety similar to insulin, though it crosses the placenta. Delivery timing is recommended at 40–41 weeks for well-controlled GDM A1, 39–39+6 weeks for GDM A2 on insulin, and 39–39+6 weeks for well-controlled PGDM; postpartum screening uses 75-g OGTT at 4–12 weeks, then every 1–3 years if normal.
Methods
- Design: narrative summary/update of the 2022 China HIP Guideline, based on the previous two editions and recently published high-quality evidence-based clinical research.
- Data/sample: no primary study sample; the paper synthesizes recommendations across 10 sections, with evidence levels and recommendation grades classified using GRADE A/B/C.
- Main analysis: presents recommendations in Table 1 with GRADE levels and cites selected supporting studies, but does not conduct a new systematic review or meta-analysis.
Limitations
- Stated: the paper is a brief summary of only the recommendations from the full guideline, with the complete reference and supporting grades/advice in the SDC file.
- Evident: there is no formal limitations section, no primary data collection, and many recommendations are Grade C (expert opinion), which limits the strength of the guidance.
- Evident: detailed evidence summaries and effect sizes are limited in this summary, so readers need the full guideline for complete evidence appraisal.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
0 of 5 cited sources checked · 0 supported · 0 flagged
In the paper
“As FPG decreases consistently with rising gestational age from 4–6 to 24–28 weeks’ gestation (Zhu, 2013);”
§ A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022) > Introduction
What the sources say
- Not matchedcites Zhu, 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Not matched
In the paper
“evidence from China of 75 women diagnosed with PGDM, according to a 2-h glucose value ≥11.1 mmol/L after 24 weeks’ gestation, who underwent an OGTT from 6 weeks to 1 year postpartum. Only eight (10.7%) women were diagnosed with DM according to the postpartum OGTT value.”
§ A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022) > Introduction
What the sources say
- Not matchedcites Wei, 2020
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, a 2-h glucose value ≥11.1 mmol/L in a 75 g OGTT during pregnancy may not be suitable for diagnosing PGDM in China.”
§ A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022) > Introduction
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Regular exercise before and during pregnancy can significantly reduce the risk of GDM in pregnant women, especially in women who are overweight or obese before pregnancy.”
§ A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022) > Introduction
What the sources say
- Not matchedcites Wang, 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Not matched
In the paper
“Moreover, 25% of women had normal postpartum OGTT values (Wei, 2020).”
§ A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022) > Introduction
What the sources say
- Not matchedcites Wei, 2020
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedn = 75Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
In the paper
“One randomized controlled trial in China showed that the risk of GDM in overweight and obese pregnant women was decreased by 45.8% with the introduction of 3 times/week cycling from early pregnancy (Wang, 2017).”
§ A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022) > Introduction
What the sources say
- Not matchedcites Wang, 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Not matched
- Probably not a substantial claim. 2
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All the evidence levels and recommendation grades were classified using the Grading of Recommendations, Assessment, Development, and Evaluations system (GRADE).”
§ A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022) > Introduction
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The update was based on the previous two editions of the guidelines along with the most recently published high quality evidence-based clinical research”
§ A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022) > Introduction
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
Hyperglycemia is one of the most common complications women encounter during pregnancy.
“Hyperglycemia is one of the most common complications women encounter during pregnancy”
The paper relies on this without support.
Hyperglycemia is associated with a higher incidence of short- and long-term health risks for both the mother and offspring.
“and is associated with a higher incidence of short- and long-term health risks for both the mother and offspring.”
The paper relies on this without support.
Hyperglycemia is clearly associated with increased risks for the mother, fetus, and neonate, including macrosomia, birth injury, cesarean section, preterm delivery, and hypertensive disorders of pregnancy.
“It includes different types of abnormal glucose metabolism and is clearly associated with increased risks for the mother, fetus, and neonate, including macrosomia, birth injury, cesarean section, preterm delivery, and hypertensive disorders of pregnancy”
The paper relies on this without support.
Hyperglycemia is associated with an increased risk of long-term metabolic syndrome in mothers and offspring.
“as well as an increased risk of long-term metabolic syndrome in mothers and offspring.”
The paper relies on this without support.
The occurrence of hyperglycemia in pregnancy (HIP) is on the rise in China.
“the occurrence of hyperglycemia in pregnancy (HIP) is on the rise in China.”
The paper relies on this without support.
Standardized management beyond pregnancy can effectively break the links between hyperglycemia and adverse maternal and fetal outcomes as well as the future health risks to mother and offspring.
“Standardized management beyond pregnancy can effectively break the links between hyperglycemia and adverse maternal and fetal outcomes as well as the future health risks to mother and offspring”
The paper relies on this without support.
Pregnant women with an HbA1C of 5.7%–6.4% during the first trimester are at high risk of developing GDM.
“Pregnant women with an HbA1C of 5.7%–6.4% during the first trimester are at high risk of developing GDM.”
The paper relies on this without support.
Elevated HbA1C levels in pre and early conception are associated with increased risk of congenital anomalies.
“Elevated HbA1C levels in pre and early conception are associated with increased risk of congenital anomalies.”
The paper relies on this without support.
Regular exercise during pregnancy can improve the blood glucose compliance rate in women with GDM and reduce the risk of an adverse outcome for mother and offspring.
“Moreover, regular exercise during pregnancy can improve the blood glucose compliance rate in women with GDM and reduce the risk of an adverse outcome for mother and offspring.”
The paper relies on this without support.
The efficacy and near-term safety of metformin during pregnancy has been shown to be similar to that of insulin.
“The efficacy and near-term safety of metformin during pregnancy has been shown to be similar to that of insulin.”
The paper relies on this without support.
Metformin has been shown to cross the placental barrier, reaching fetal circulation.
“Metformin has been shown to cross the placental barrier, reaching fetal circulation.”
The paper relies on this without support.
No obvious adverse effects of metformin on offspring have been found.
“However, no obvious adverse effects of metformin on offspring have been found.”
The paper relies on this without support.
Continuous glucose monitoring (CGM) helps to achieve an optimum level of HbA1c and reduce the risk of macrosomia and neonatal hypoglycemia in pregnant women with T1DM.
“Continuous glucose monitoring (CGM) helps to achieve an optimum level of HbA1c and reduce the risk of macrosomia and neonatal hypoglycemia in pregnant women with T1DM.”
The paper relies on this without support.
CGM cannot replace self-monitoring of blood glucose to achieve optimum blood glucose control.
“CGM cannot replace self-monitoring of blood glucose to achieve optimum blood glucose control.”
The paper relies on this without support.
The level of serum lipids in pregnancy is higher than that in non-pregnancy, which is an adaptive change for mothers to give priority to the supply of nutrition to the fetus.
“The level of serum lipids in pregnancy is higher than that in non-pregnancy, which is an adaptive change for mothers to give priority to the supply of nutrition to the fetus.”
The paper relies on this without support.
An abnormal lipid level increase during pregnancy is associated with an adverse pregnancy outcome.
“However, an abnormal lipid level increase during pregnancy is associated with an adverse pregnancy outcome.”
The paper relies on this without support.
GDM is associated with an increased risk for type 2 diabetes mellitus (T2DM).
“GDM is associated with an increased risk for T2DM”
The paper relies on this without support.
Newborns of mothers with HIP are high-risk infants for hypoglycemia.
“Newborns of mothers with HIP are high-risk infants for hypoglycemia.”
The paper relies on this without support.
High risk factors of GDM include race and maternal factors; for example advanced age, overweight or obesity before pregnancy, excessive weight gain during pregnancy, polycystic ovary syndrome, family history of diabetes, history of GDM, delivery history of macrosomia, multiple pregnancies, and hypertensive disorder during pregnancy.
“High risk factors of GDM include race and maternal factors; for example advanced age, overweight or obesity before pregnancy, excessive weight gain during pregnancy, polycystic ovary syndrome, family history of diabetes, history of GDM, delivery history of macrosomia, multiple pregnancies, and hypertensive disorder during pregnancy.”
The paper relies on this without support.
The prevention of GDM includes diet, exercise, inositols, and vitamin D supplementation, which may play a role in the prevention of GDM.
“The prevention of GDM includes diet, exercise, inositols, and vitamin D supplementation, which may play a role in the prevention of GDM.”
The paper relies on this without support.
Hypoglycemia during pregnancy is common in women with T1DM and T2DM.
“it is common in women with T1DM and T2DM.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Two snacks cannot complete the stated daily energy allocation
MinorWith two snacks, the maximum stated allocations are 15% for breakfast, 30% each for lunch and dinner, and 10% per snack. These total only 95% of daily energy, so the permitted two-snack schedule cannot follow the stated allocation.
“three regular meals and 2–3 extra snacks a day.”
“The energy levels of breakfast, lunch, and evening meals should be 10%–15%, 30%, and 30% of the total daily energy intake, respectively, and the energy of each additional snack should account for 5%–10%.”
Citations
Cites
(2022) · International SoC Design Conference · doi:10.1109/isocc56007.2022.10031333 · Cited by 2,099
Flagged first, then by citations
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Call to action for a life course approach
Simmons, D. S., Gupta, Y., Hernandez, T. L., Levitt, N. S., van Poppel, M. N. M., Yang, X., Zarowsky, C., BACKMAN, H. E., Feghali, M. N., & Nielsen, K. K. (2024) · The Lancet · doi:10.1016/s0140-6736(24)00826-2 · Cited by 77
Universal screening for hyperglycemia in early pregnancy and the risk of adverse pregnancy outcomes
Shen, L., Zhang, S., Wen, J., Liu, J., Lin, X., Zhu, C., Cai, S., Xie, L., Wang, Z., & Chen, H. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07253-4 · Cited by 13
“The Chinese guideline recommends that an FPG of 5.6–6.9 mmol/L be defined as impaired glucose metabolism based on the previous ADA recommendation in 2021 [6].”
InfluentialChen, B., Chen, X., Li, J., Hu, R., Yang, L., Li, H., Liu, X., Cannon, R. D., Saffery, R., Novakovic, B., et al. (2025) · Cell Reports · doi:10.1016/j.celrep.2025.116505 · Cited by 10
Lai, Y., Wang, C., Ouyang, J., Wu, L., Wang, Y., Wu, P., Ye, Y.-X., Yang, X., Gao, Y., Wang, Y.-X., et al. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.04.003 · Cited by 5
DiStefano, M. J., McQueen, R. B., Gao, V., et al. (2024) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2024.0478 · Cited by 5
Metadata
- Authors
- Maternal-Fetal Medicine Committee, C. S. O. O. A. G., Wang, C., Juan, J., & Yang, H.
- Affiliations
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
- Peking University First Hospital (CN)
- ORCID
- Yang, Huixia
- Venue
- Maternal-Fetal Medicine
- Published
- 2023-01
- Volume
- 5
- Issue
- 1
- Pages
- 4-8
- ISSN
- 2096-6954 (ISSN-L)
- 2641-5895
- PMC
- PMC12106219
- OpenAlex
- W4319262516
- Semantic Scholar
- 3a0f0fdc7098928ff9daff6476c1bf2bb0daae67
- Cited by
- 21
- References
- 1
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 3
- FWCI
- 5.71
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Maternal-Fetal Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Shandong University
- Qilu Hospital of Shandong University
- Peking University First Hospital
- National Natural Science Foundation of China (81830044)
- Sun Yat-sen University
- Zhejiang University
- Nanjing Medical University
- Peking University
- National Key Research and Development Program of China (2021YFC2700700)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- hyperglycemia in pregnancy, gestational diabetes mellitus, diagnosis, management, screening, blood glucose monitoring, treatment, prevention, maternal and child health
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