Diagnostic criteria for gestational diabetes: The debate goes on

Rodríguez-Hervada, A. Duran; Pascual, Alfonso Luis Calle

doi:10.1016/j.endoen.2015.05.003

Cited by 5 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Gestational diabetes mellitus is the most common form of HIP, accounting for approximately 80-85% of all cases (the other two forms of HIP, i.e., overt diabetes and pre-existing diabetes, account for about 15-20% of all cases) [1,15,16]. The criteria for diagnosis of GDM have been a matter of intense debate and constantly evolved over the past few decades [17][18][19][20][21][22][23]. At present, most global bodies recommend the use of IADPSG criteria, which define GDM as the presence of one or more of the three abnormal values (C 92 mg/dl (5.1 mmol/ L), 180 mg/dl (10.0 mmol/L), or 153 mg/dl (8.5 mmol/l) at 0, 1, and 2 h, respectively) on a 75-g oral glucose tolerance test (OGTT) performed in a fasting state during pregnancy [6].…”

Section: Overt Diabetes In Pregnancy: Definition Vis-a `-Vis Gestatio...mentioning

confidence: 99%

Overt Diabetes in Pregnancy

2022

View full text Add to dashboard Cite

Aims: Overt diabetes in pregnancy is defined as hyperglycemia first recognized during pregnancy which meets the diagnostic threshold of diabetes in non-pregnant adults. This casebased narrative review aims to describe this unique condition and discuss the potential implications for its accurate diagnosis and management. Methods and Results: We conducted a literature search in PubMed for relevant articles published in English language up to January 2022. Women with overt diabetes have a higher risk for adverse pregnancy outcomes and postpartum diabetes, compared to their counterparts with gestational diabetes mellitus (GDM). Such women often need aggressive management, including early and prompt initiation of insulin therapy, and a close follow-up during pregnancy and in the postpartum period. Not all pregnant women with overt diabetes have persistent diabetes in the postpartum period. Early diagnosis, especially during the first trimester, and fasting plasma glucose elevation (C 126 mg/dl or 7 mmol/L) at the time of initial diagnosis are predictors of postpartum diabetes. Conclusions: Both GDM and overt diabetes in pregnancy are hyperglycemic conditions first recognized during pregnancy, but the two conditions differ in severity; the latter is a more severe form of hyperglycemia associated with worse maternal and fetal outcomes, and a higher risk of postpartum diabetes.

show abstract

Section: Overt Diabetes In Pregnancy: Definition Vis-a `-Vis Gestatio...mentioning

confidence: 99%

Overt Diabetes in Pregnancy

2022

View full text Add to dashboard Cite

show abstract

“…Several studies among them reported the appropriateness of 2-hour glucose value in the diagnosis of the disease, whereas some other studies state the importance of having all three measurements in the diagnosis. [8][9][10][11] Therefore, the reliability of using a single value alone in the standard OGTT procedure is a matter of concern. Hence, the present study was undertaken with the intent of assessing the validity of individual glucose values in 75g OGTT, in order to modify the test procedure to make it more convenient, efficient, and cost effective for the accurate diagnosis of GDM.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic significance of individual glucose values in oral glucose tolerance test and the associated risk factors for gestational diabetes mellitus in pregnant mothers: A cross-sectional study

De Silva,

Dissanayake,

Amarasiri

2023

J of Cey Coll of Phy

View full text Add to dashboard Cite

Background: The diagnosis of gestational diabetes mellitus (GDM) is mainly based on oral glucose tolerance test (OGTT) in Sri Lankan clinical setting. The present study was to assess the diagnostic significance of individual glucose values in 75g OGTT in a group of pregnant mothers, to modify the test procedure to make it more convenient and cost-effective and to identify the associated risk factors for GDM.Methods: A total of 150 pregnant women within the second trimester and attending the antenatal clinics at Teaching Hospital Mahamodara were recruited for the study. Data collection was carried out via an interviewer-administered questionnaire followed by retrieval of laboratory data on OGTT.Results: Seventeen pregnant women (11.33%) were diagnosed with GDM by OGTT based on the WHO criteria. Diagnosis was based on either fasting or 2-hour glucose values alone or by increased levels in more than one of those parameters. None of them were diagnosed based on the 1-hour glucose value alone. The AUC values were 0.951 (0.884, 1.000), 0.829 (0.715, 0.942) and 0.859 (0.776, 0.943) respectively for fasting, 1-hour and 2-hour glucose concentrations (CI 95%). GDM was associated with uncontrolled sweet consumption (X2=5.86, p=0.015) and no association was observed with reference to maternal age, parity, BMI, positive family history of diabetes, and prior history of GDM or diabetes mellitus.Conclusion: Fasting and 2-hour plasma glucose values have higher diagnostic accuracy over 1-hour glucose values and the findings suggest the performance of fasting and 2-hour samples alone in the standard 75g OGTT procedure for the diagnosis of GDM.

show abstract

Improved gestational diabetes screening protocol

Rojas¹,

Roger

Grúa³

et al. 2021

Advances in Laboratory Medicine / Avances en Medicina De Laboratorio

View full text Add to dashboard Cite

Objectives This work aimed to assess the diagnostic validity of two approaches for the screening of gestational diabetes mellitus (GDM) with less discomfort for pregnant women. Methods A prospective diagnostic validation study was conducted with 2007 pregnant women. According to risk factors for GDM, women were classified into high-risk and low-risk groups. The current diagnostic procedure, based on oral glucose overload, was followed; simultaneously HbA1c was tested and an algorithm combining both biomarkers was applied. Results In the low-risk group, the Glucose challenge test (GCT) showed a higher area under the curve (AUC 0.953; 95% CI 0.915–0.992) than the HbA1c test (0.688; 95% CI 0.541–0.834). The best GCT cut-off, 153.5 mg/dL (8.52 mmol/L), showed higher diagnostic validity than that for HbA1c, 28 mmol/mol (4.75%), and that the algorithm using both tests. In the high-risk group, the GCT showed better diagnostic performance than the HbA1c and the algorithm; the optimal GCT cut-offs were higher than those recommended in current protocols. 13th week: GCT AUC 0.882 (95% CI 0.843–0.921), HbA1c AUC 0.624 (95% CI 0.562–0.686), GCT cut-off 140.5 mg/dL (7.8 mmol/L), HbA1c cut-off 33 mmol/mol (5.15%). 24th week: GCT AUC 0.944 (95% CI 0.925–0.962), HbA1c AUC 0.642 (95% CI 0.575–0.709), GCT cut-off, 145.5 mg/dL (8.08 mmol/L), HbA1c cut-off 29 mmol/mol (4.85%). Conclusions The GDM diagnostic approach using as the first step the GCT with higher cut-offs showed the best diagnostic validity. Applying these thresholds, 55.6 and 13.7% of 100 g. Oral glucose overloads would have been avoided in low-risk and high-risk pregnant women.

show abstract

Diagnostic criteria for gestational diabetes: The debate goes on

Cited by 5 publications

References 19 publications

Overt Diabetes in Pregnancy

Overt Diabetes in Pregnancy

Diagnostic significance of individual glucose values in oral glucose tolerance test and the associated risk factors for gestational diabetes mellitus in pregnant mothers: A cross-sectional study

Improved gestational diabetes screening protocol

Contact Info

Product

Resources

About