Priscilla White classification of Diabetes complicating pregnancy

  • Priscilla White was a pioneer in the treatment of Diabetes complicating pregnancy
  • She proposed the famous White classification
  • It emphasizes the importance of 3 factors
    • Age of patient
    • Duration of diabetes
    • Presence of vasculopathy
  • It was modified by the American College of Obstetricians and Gynaecologists in 1986
  • The original version consists of 7 classes
  • The modified version splits class A – consisting of patients who developed diabetes during pregnancy – into 2 subcategories – A1 and A2
  • A1 corresponds to those who have carbohydrate intolerance detected during 100g 3 hour glucose tolerance test, but fasting and post prandial glucose levels are less than 105mg/dl and 120mg/dl respectively
  • In the A2 subcategory, the fasting and post prandial glucose levels are more than 105mg/dl and 120mg/dl respectively

Classification of Diabetes complicating pregnancy
Part 1 – Gestational diabetes

Class Onset Fasting Plasma Glucose 2 hour postprandial glucose Therapy
A1 Gestational <105mg/dl <120mg/dl Diet
A2 Gestational >105mg/dl >120mg/dl Insulin

Part 2 – Overt diabetes

Class Age of Onset Duration (years) Vascular disease Therapy
B Over 20 <10 None Insulin
C 10-19 10-19 None Insulin
D >20 >20 Benign retinopathy Insulin
E Any Any Nephropathy Insulin
R Any Any Proliferative retinopathy Insulin
G Any Any Cardiac involvement Insulin

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