Comparison of the International Association of Diabetes in Pregnancy Study Group Criteria with the Old American Diabetes Association Criteria for Diagnosis of Gestational Diabetes Mellitus

Long

et al. 2021

WJD

BACKGROUND Melatonin is reported to be related to diabetes mellitus (DM) risk; however, the effect of melatonin on diabetic retinopathy (DR) risk remains unclear. AIM The aim of this study was to determine the effect of melatonin on DR risk. METHODS A hospital-based case-control study was conducted from January 2020 to June 2020. DR was assessed using the Diabetic Retinopathy preferred practice pattern (PPP)-updated 2019 criteria. The participants were divided into the DM cases without DR (NDR) group, non-proliferative DR (NPDR) group and proliferative DR (PDR) group. Plasma melatonin concentration was detected with the enzyme-linked immunosorbent assay kit. The relationship between plasma melatonin concentration and DR risk as well as severity was assessed. RESULTS It was found that plasma melatonin was 72.83 ± 16.25, 60.38 ± 13.43, 44.48 ± 10.30 and 44.69 ± 8.95 pg/mL in healthy controls, NDR group, NPDR and PDR group, respectively. In addition, it was found that plasma melatonin could be used as a potential diagnostic biomarker for DR (AUC = 0.893, P < 0.001). There was a significant positive relationship between total bilirubin and melatonin content ( P < 0.001) based on the correlation assay. Significant associations between total bilirubin and melatonin content were also detected in the NPDR ( R 2 = 0.360, P < 0.001) and PDR ( R 2 = 0.183, P < 0.001) groups. CONCLUSION The data obtained in this study demonstrated that plasma melatonin concen-tration was decreased in DR cases and could be used as a sensitive and specific marker for the diagnosis of DR. A significant positive relationship between total bilirubin and melatonin was detected. More related studies are required to understand the role of melatonin in DR.

Section: Methodsmentioning

confidence: 99%

Plasma melatonin levels in patients with diabetic retinopathy secondary to type 2 diabetes

Long

et al. 2021

WJD

“…In this regard, various studies investigated the possible risk factors associated with incidence of GDM. GDM was significantly higher in pregnant women with older age, poorer glycemic control, and higher BMI, which may be due to the reduction of insulin sensitivity in those women [1,4,6,8]. Most of the studies assessed the diagnostic accuracy of lowest FPG level in diagnosing GDM and only few studies assessed the diagnostic accuracy of lowest FPG level in ruling out GDM.…”

Section: Discussionmentioning

confidence: 99%

“…Gestational diabetes mellitus (GDM), defined as diabetes diagnosed during pregnancy in women without overt diabetes mellitus (DM), is one of the most important and common metabolic disorders during pregnancy [1]. GDM had wide range growing prevalence in different studies from 7.9 to 24.9% [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Can fasting plasma glucose replace oral glucose-tolerance test for diagnosis of gestational diabetes mellitus?

et al. 2021

Self Cite

Background and aims Gestational diabetes mellitus (GDM) has high prevalence worldwide. This study aimed to evaluate the fasting plasma glucose (FPG) cutoffs at first prenatal visit and at 24-28th of gestational weeks to avoid obtaining full oral glucose-tolerance test (OGTT) in the diagnosis of GDM. Methods This study was a cross-sectional study conducted in Tehran, Iran during October 2016 and November 2017. All pregnant women reporting for the first routine prenatal visit before 20th week of gestational age were included in this study. Participants without overt diabetes mellitus at first prenatal visit, underwent OGTT at 24-28th of gestational weeks. Results Totally 952 pregnant women with mean age of 26.4 ± 14.1 years took part in this study. The prevalence of GDM was 12.7% (mostly diagnosed based on the FPG alone). FPG cutoffs 75 and 80 mg/dL at first prenatal visit and at 24-28th of gestational weeks can rule out the GDM with high sensitivity and negative predictive value, respectively. FPG cutoffs 85 and 90 mg/dL at first prenatal visit and at 24-28th of gestational weeks had high capacity, excellent specificity and positive predictive value in diagnosing GDM, respectively. Conclusions Performing only the FPG and considering FPG cutoffs 75 and 80 mg/dL at first prenatal visit and at 24-28th of gestational weeks can be a useful tool predicting the incidence of GDM, respectively, and had similar diagnostic power.

“…On the other hand, the increasing prevalence of overweight and obesity in recent years has been associated with the increasing prevalence of GDM, based on the IADPSG criteria, which exceeds all previous records. In this regard, two recent Iranian studies from Isfahan ( 9 ) and Tehran ( 10 ) reported the higher prevalence of GDM based on the IADPSG criteria (15.6% and 9.3%, respectively) than based on the old two-step criteria (7.1% and 4.2%, respectively). Moreover, two recent meta-analyses, one including nine observational studies and one including four clinical trials, showed adverse pregnancy and prenatal outcomes in GDM patients diagnosed by either method.…”

Section: Contextmentioning

confidence: 94%

Iranian Endocrine Society Guidelines for Screening, Diagnosis, and Management of Gestational Diabetes Mellitus

Hosseinpanah

Tehrani

Abdi

et al. 2020

Int J Endocrinol Metab

Self Cite

Context: Gestational diabetes mellitus (GDM) is an important endocrine disorder in perinatology, associated with several maternal and neonatal complications. Development of national guidelines can inform clinicians, health policymakers, and researchers about the most recent evidence and practical issues of diagnosis and management of GDM. Objectives: We aimed to develop clinical practice guidelines for the diagnosis and management of GDM in Iranian pregnant women. Evidence Acquisition: The Iranian Endocrine Society constituted a task force, consisting of obstetrician-gynecologists, endocrinologists, a clinical nutritionist, a clinical epidemiologist, and a librarian, to review the published literature and propose national guidelines for the diagnosis and management of GDM. The consensus was reached on all recommendations in several group meetings with a majority decision. The evidence and recommendations were graded according to the American College of Physicians’ Guideline Grading System. Results: The proposed guidelines included recommendations for screening, diagnosis, and management of GDM in Iran. Conclusions: By using an evidence-based approach, these national GDM guidelines can address important clinical issues in the diagnosis and management of Iranian women with GDM.