Frequency of Gestational Diabetes Mellitus at Collaborating Centers Based on IADPSG Consensus Panel–Recommended Criteria

Abstract

OBJECTIVETo report frequencies of gestational diabetes mellitus (GDM) among the 15 centers that participated in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study using the new International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria.RESEARCH DESIGN AND METHODSAll participants underwent a 75-g oral glucose tolerance test between 24 and 32 weeks’ gestation. GDM was retrospectively classified using the IADPSG criteria (one or more fasting, 1-h, or 2-h plasma glucose concentrations equal to or greater than threshold values of 5.1, 10.0, or 8.5 mmol/L, respectively).RESULTSOverall frequency of GDM was 17.8% (range 9.3–25.5%). There was substantial center-to-center variation in which glucose measures met diagnostic thresholds.CONCLUSIONSAlthough the new diagnostic criteria for GDM apply globally, center-to-center differences occur in GDM frequency and relative diagnostic importance of fasting, 1-h, and 2-h glucose levels. This may impact strategies used for the diagnosis of GDM.

Oxidative stress in pregnancy and fertility pathologies

“…In contrast, a very recent study did not find differences in both oxidative stress biomarkers (malondialdehyde (MDA) and protein carbonyls) and antioxidant capacity (GSSG, reduced glutathione (GSH) and glutathione peroxidase) between control and GDM placentas (Araújo et al 2013). However, as stressed by the authors, the reason for the apparent discrepancy relates to the fact that women in the GDM group were diagnosed according to the new IADPSG criteria (Sacks et al 2012), which encompass women with a less severe diabetic phenotype. For most of the abovementioned studies, GDM women were treated by controlled nutrition and/or insulin administration.…”

“…Although it was classically estimated to develop in 2-5 % of pregnancies, according to the new International Association of the Diabetes and Pregnancy Study Groups (IADPSG) Consensus Panel diagnostic criteria, the prevalence has significantly increased to about 18 % of all pregnancies (Sacks et al 2012). GDM develops around the second half of gestation (by the time the placental villi undergoes extensive angiogenesis and vascularization) and has a significant role in fetal macrosomia, perinatal mortality, and long-term risk of developing type 2 diabetes mellitus for the mother, which is why it is considered a "pre-diabetic" state (Coughlan et al 2004b;Gauster et al 2012;Myatt and Cui 2004).…”

A computational model of 1,5-AG dynamics during pregnancy

“…(B) Plasma volume, using longitudinal data from approximately 69 healthy females throughout seven times in pregnancy (Sacks et al. 2012) and fitting to a sigmoidal curve (eq. 4).…”

“…2012). Due to the 3–4 month timeline by which HbA1c levels fluctuate, HbA1c does not optimally capture intermediate‐term glycemic excursions during the critical 9 month period of gestation.…”

Gestational Diabetes Mellitus 1,2

“…5,6 Recently, the prevalence of GDM has increased by 2-3 folds, ranging from 8.9-53.4%. [7][8][9][10][11][12][13][14][15][16] This is mainly due to the adoption of the new criteria proposed by the IADPSG on screening, and diagnosis of GDM. 3 The IADPSG recommends universal screening for GDM, and requires one single glucose value above the cut-off value (instead of 2) during the oral glucose tolerance test (OGTT) for diagnosis.…”