Classification of diabetes: The White classification, named after Priscilla White who pioneered research on the effect of diabetes types on perinatal outcome, is widely used to assess maternal and fetal risk. It distinguishes between gestational diabetes (type A) and diabetes that existed before pregnancy (pregestational diabetes). These two groups are further subdivided according to their associated risks and management. There are 2 classes of gestational diabetes (diabetes which began during pregnancy): Class A1: gestational diabetes; diet controlled Class A2: gestational diabetes; insulin controlled The second group of diabetes which existed before pregnancy can be split up into these classes: Class B: onset at age 20 or older or with duration of less than 10 years Class C: onset at age 10-19 or duration of 10–19 years Class D: onset before age 10 or duration greater than 20 years Class E: overt diabetes mellitus with calcified pelvic vessels Class F: diabetic nephropathy Class R: proliferative retinopathy Class RF: retinopathy and nephropathy Class H: ischemic heart disease Class T: prior kidney transplant An early age of onset or long-standing disease comes with greater risks, hence the first three subtypes
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Class B1 gestational diabetes means the patient had an onset at age 20 or older and the type is not necessary as unspecified will always code out to type 2. So what that documentation is really saying is the patient already had diabetes prior to becoming pregnant, the wording of gestational Class B1 diabetes is just saying that the patient has dm during pregnancy(gestational) and NOT pregnancy induced(gestational Class A1 or A2).