Abstract: Objective To explore the application value combined detection of fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol (TC) and triglyceride (TG) in diagnosis of gestational diabetes mellitus (GDM) in early pregnancy. Methods A total of 117 GDM high-risk pregnant women were selected in our hospital from July 2016 to August 2017 in the obstetrics department, and they were divided into GDM group and normal group according to GDM diagnostic criteria, the levels of glucose and lipid metabolism were compared between the two groups, at the same time, the levels of glucose and lipid metabolism were detected in early pregnancy (within 12 weeks of pregnancy), and compared with the diagnosis results of GDM, the diagnostic value of each glycolipid metabolism index alone and the combined detection in GDM were compared. Results According to the GDM diagnostic criteria, the results showed that of the 117 pregnant women, 62 were pregnant with GDM and 55 were normal; The levels of FBG, HbA1c, TC and TG were significantly higher in the GDM group than in the control group (all P<0.05). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Kappa value of HbA1c detection were the highest (88.71, 72.73, 81.20, 78.57, 80.85 and 0.619, respectively). The AUC values of FBG, HbA1c, TC and TG were 0.868, 0.885, 0.681 and 0.688, respectively, and the AUC value of the joint detection was 0.958, the AUC values of the joint detection were compared with the AUC values of FBG, HbA1c, TC and TG, the differences were statistically significant (P<0.05). Conclusion In the early stage of pregnancy, the joint detection of glucose and lipid metabolism in GDM has high diagnostic value, which can provide a reference for the diagnosis and treatment of GDM in the early stage of pregnancy.