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The U.S. Preventive Services Task Force recommends screening pregnant patients for gestational diabetes at or after 24 weeks of pregnancy to improve pregnancy outcomes (JAMA 2021 326:531), but the optimal approach to diagnosing gestational diabetes is unknown. To compare two thresholds for diagnosing gestational diabetes by a 75-gram glucose tolerance test, researchers conducted a trial involving 4061 pregnant patients at 24 to 32 weeks' gestation. Patients were randomized to either a lower diagnostic threshold (fasting plasma glucose, 92 mg/dL; 1-hour, 180 mg/dL; or 2-hour, 153 mg/dL) or a higher threshold (fasting, 99 mg/dL; or 2-hour, 162 mg/dL). Trial participants, clinicians, and research staff were informed about diagnoses of gestatio…