Background
In 2010 the International Association of Pregnancy Study groups ( IADPSG) first published its recommendations for the diagnosis of gestational diabetes in wake of the HAPO study results. 
They introduced a new definition of Gestational Diabetes by including those women with a fasting Glucose of  equal to or more than 5.1 to 6.9 mmol/l as being diagnosed as Gestational Diabetics. 

Aim
We at Corniche hospital in Abu Dhabi implemented these recommendations as of 1rst January 2012. We decided to look at our hospital population and see how many patients were diagnosed at < 20 weeks of gestation with Gestational Diabetes. What was their further progress in pregnancy and what was there pregnancy outcome.
To ascertain whether this is a valid method of testing for Gestational Diabetes 

Method
Prospective Observational Study from 1st January 2016 till 31st December 2016. 
Electronic medical records of all those patients who were diagnosed as GDM by means of their fasting glucose prior to 20 weeks gestation were scrutinized.
The blood glucose profiles of these women were studied and level of glycemic control established.

Results
During the study period 6,970 women registered their pregnancies in Corniche Hospital. 546 women i.e. 8% had pre existing diabetes. The remainder (6,244) were requested to do a Fasting Glucose Screen. Of these  only 1,781 did have the test done of which 355 were abnormal. Thus 20% of these pregnant women were diagnosed as having gestational diabetes in the first trimester.
They were channeled into dietary intervention and self monitoring of blood glucose. 

Discussion
Testing for Gestational Diabetes in the first trimester does not have a large evidence base. However researchers have published inconsistent results. We believe that in our population where there is a high incidence of type 2 Diabetes, there is also an increased risk of pre diabetes which would manifest in pregnancy as Gestational Diabetes.

Implementation of IADPSG recommendations and the subsequent outcomes