Strategies for implementing the WHO diagnostic criteria and classification of hyperglycaemia first detected in pregnancy

Colagiuri, Stephen; Falavigna, Maicon; Agarwal, Mukesh; Boulvain, Michel; Coetzee, E. J.; Hod, Moshe; Meltzer, S. J.; Metzger, Boyd E.; Omori, Yasue; Rasa, Ingvars; Schmidt, María Inês; Seshiah, V.; Simmons, David; Sobngwi, Eugène; Torloni, Maria Regina; Yang, Hui

doi:10.1016/j.diabres.2014.02.012

Cited by 102 publications

(91 citation statements)

References 48 publications

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“…The comparison of demographic changes among the studied groups that showed no significant differences removed the effects those parameters could have on The diagnosis of GDM is more among studied subjects using IASDAPG [14] guideline than when WHO [15] criteria was used, this is because Fasting Plasma Glucose (FPG) limit for diagnosis is lower than that accepted with WHO. Plasma glucose values with these two guidelines will predict Diabetes Mellitus better than expected in normal non pregnant population.…”

Section: Discussionmentioning

confidence: 99%

“…As shown in Table 3 below, women with GDM were diagnosed based on the guidelines as presented by IASDAPG (FBS = 5.1 mmol/l, 1 hr = 10 mmol/l), 2 hr = 8.5 mmol/l) [14] and WHO (FBS = 6 mmol/l) 2 hr = 7.8 mmol/l) [15]. Higher numbers of women were diagnosed of having GDM using IASDAPG criteria than when WHO criteria were used.…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Table 1 and Table 2, all results of three-point OGTT of all recruited subjects were interpreted using the guidelines as set by International Association of Diabetes and Pregnancy Study Groups (IADAPSG) [14] and World Health Organisation (WHO) [15] separately. It showed, as presented in Table 3 below, that more women were diagnosed of having GDM (n = 23) when IADAPSG criteria were used then when WHO criteria were used (n = 16).…”

Section: Resultsmentioning

confidence: 99%

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Maternal Plasma Lipid Profile in Women Screened for Gestational Diabetes Mellitus (GDM)

Atiba¹,

Olofinbiyi²,

Akintunde³

et al. 2017

OJOG

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Objective: This is to determine the plasma lipid profile status of patients diagnosed with gestational diabetes mellitus. Methodology: Seventy-nine pregnant women between gestational age of 24 and 28 weeks out of which 23 and 16 were diagnosed of having GDM using IADAPSG and WHO guidelines respectively were recruited into the study. Plasma lipid profile was determined among the study groups using standard laboratory techniques. Results: Higher numbers of women were diagnosed with GDM using IASDAPG criteria than when WHO criteria were used. Plasma lipid profile showed no significant difference between women with GDM and Non-GDM irrespective of guidelines used in the diagnosis of GDM. Conclusion: Pregnancy and Gestational Diabetes Mellitus may have influence on lipid metabolism but not likely in the second trimester of pregnancy as observed in our study.

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Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Maternal Plasma Lipid Profile in Women Screened for Gestational Diabetes Mellitus (GDM)

Atiba¹,

Olofinbiyi²,

Akintunde³

et al. 2017

OJOG

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“…Alternatives to aid implementation were also proposed. 7 In 2015, the British National Institute for Health and Care Excellence (NICE) 8 …”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of women with gestational diabetes - comparison of two cohorts enrolled 20 years apart in southern Brazil

et al. 2017

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CONTEXT AND OBJECTIVE: The prevalence and characteristics of gestational diabetes mellitus (GDM) have changed over time, reflecting the nutritional transition and changes in diagnostic criteria. We aimed to evaluate characteristics of women with GDM over a 20-year interval. DESIGN AND SETTING: Comparison of two pregnancy cohorts enrolled in different periods, in university hospitals in Porto Alegre, Brazil: 1991 to 1993 and 2009 to 2013 (n = 375). METHODS:We applied two diagnostic criteria to the cohorts: International Association of Diabetes and Pregnancy Study Groups (IADPSG)/World Health Organization (WHO); and National Institute for Health and Care Excellence (NICE). We compared maternal-fetal characteristics and outcomes between the cohorts and within each cohort. RESULTS:The women in the 2010s cohort were older (31 ± 7 versus 30 ± 6 years), more frequently obese (29.4% versus 15.2%), with more hypertensive disorders (14.1% versus 5.6%) and at increased risk of cesarean section (adjusted relative risk 1.8; 95% confidence interval: 1.4 -2.3), compared with those in the 1990s cohort. Neonatal outcomes such as birth weight category and hypoglycemia were similar. In the 1990s cohort, women only fulfilling IADPSG/WHO or only fulfilling NICE criteria had similar characteristics and outcomes; in the 2010s cohort, women only diagnosed through IADPSG/WHO were more frequently obese than those diagnosed only through NICE (33 ± 8 kg/m 2 versus 28 ± 6 kg/m 2 ; P < 0.001). CONCLUSION: The epidemic of obesity seems to have modified the profile of women with GDM. Despite similar neonatal outcomes, there were differences in the intensity of treatment over time. The IADPSG/ WHO criteria seemed to identify a profile more associated with obesity. RESUMO

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“…Local approaches for diagnosing and monitoring of major non-communicable diseases and their risk factors have been encouraged. 23,24 Consequently, the burden of hyperglycaemia in pregnancy will need to be evaluated by local health services to determine the best strategy for testing and treating hyperglycaemia in pregnancy. In this study, we reviewed the records of women screened for GDM in our centre to evaluate the significance of these recent changes in classification of hyperglycaemia among pregnant Nigerian women.…”

Section: Introductionmentioning

confidence: 99%

Modification of WHO diagnostic criteria for gestational diabetes: implications for classification of hyperglycemia in pregnancy

Imoh

Asorose

Odo

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Low and medium income countries (LMICs) especially in sub-Saharan Africa face unique challenges in screening and diagnosing hyperglycaemia in pregnancy. The implications of applying the 2013 WHO modifications for assessing hyperglycaemia in pregnancy in low resource settings are not known. We evaluated the significance of these recent changes in classification of hyperglycaemia among pregnant Nigerian women.Methods: We reviewed the records of Oral glucose tolerance test conducted on 600 pregnant women at the Jos University Teaching Hospital (JUTH) between July 2012 and June 2016. The collected data were analyzed using Statistical Package for Social Sciences version 18 (SPSS Inc., Chicago, IL, USA). Test for association was done using Fisher’s exact test. P < 0.05 was set as the level of significance.Results: The results show that 15.9%, 20.2% and 15.7% of the women had GDM according to WHO (1999), IADPSG and WHO (2013) diagnostic criteria respectively while 4.8% of the women had DM in pregnancy by WHO 2013 criteria. Overall, 30.2% and 23.9% of women who were classified as GDM by WHO 1999 criteria and IADPSG criteria respectively were qualified to be classified as DM in pregnancy according to the WHO 2013 criteria.Conclusions: The recent Modifications by the WHO 2013 guideline for classifying hyperglycemia in pregnancy may create non-uniform interpretation of OGTT. The confusion in classifying hyperglycemia among pregnant women referred between health centres may become more pronounced. There is an urgent need for a streamlined globally acceptable approach to assessing and classifying hyperglycemia in pregnant women.

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Strategies for implementing the WHO diagnostic criteria and classification of hyperglycaemia first detected in pregnancy

Cited by 102 publications

References 48 publications

Maternal Plasma Lipid Profile in Women Screened for Gestational Diabetes Mellitus (GDM)

Maternal Plasma Lipid Profile in Women Screened for Gestational Diabetes Mellitus (GDM)

Clinical characteristics of women with gestational diabetes - comparison of two cohorts enrolled 20 years apart in southern Brazil

Modification of WHO diagnostic criteria for gestational diabetes: implications for classification of hyperglycemia in pregnancy

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