Gestationsdiabetes: aktuelle Screening- und diagnostische Aspekte/Gestational diabetes: current screening and diagnostic aspects

2011 ◽  
Vol 35 (4) ◽  
pp. 179-182
Author(s):  
Michael Bolz ◽  
Sabine Körber ◽  
Volker Briese ◽  
Michael Steiner
Keyword(s):  
Gestational Diabetes ◽  
Diagnostic Aspects ◽  
Current Screening ◽  
Diagnostische Aspekte

scholarly journals Early Onset Acceleration of Fetal Growth in Gestational Diabetes Mellitus: Deciding About When and Whom to Screen for Preventing Fetal Macrosomia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A353-A353
Author(s):  
Maria Mirabelli ◽  
Eusebio Chiefari ◽  
Paola Quaresima ◽  
Federica Visconti ◽  
Daniela Foti ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fetal Growth ◽  
Early Onset ◽  
Abdominal Circumference ◽  
Fetal Macrosomia ◽  
Screening Strategies ◽  
Initial Acceleration ◽  
Current Screening

Abstract The precise time into pregnancy at which women are screened for gestational diabetes mellitus (GDM) is crucial for determining the benefits of diagnosis. However, this issue remains a source of intense debate among guidance authorities and there is no consensus about when and whom to screen. Since 2010, the IADPSG recommends universal screening with 75g OGTT at 24–28 weeks’ gestation (WG), due to evidence of a positive linear correlation between maternal blood glucose levels around 28 WG and risk of fetal macrosomia. Nonetheless, emerging evidence indicates that initial acceleration of fetal growth (FG) related to GDM, predicting fetal macrosomia, is already underway at 20 WG, thereby suggesting that screening strategies for GDM earlier than the recommended 24–28 WG should be reconsidered (1). By exploiting the routine 19–21 WG obstetrical assessment of FG (anomaly scan), along with the risk stratification system endorsed by the Italian NHS, which offers, in addition to the usual GDM screening test at 24–28 WG, an early 75g OGTT at 16–18 WG to women who are classified as at high risk (HR) for GDM (i.e. previous GDM, pre-gravid obesity, or FPG at first prenatal visit between 5.6–6.9 mmol/L), we aimed to verify whether an early onset acceleration of FG related to GDM would be observed in our pregnant population, and if reversion could occur with current screening recommendations. For this, 769 consecutive women in singleton pregnancies, subjected to both anomaly scan and GDM screening, were retrospectively enrolled at our Institution between Jan 2018-Feb 2020. At a mean time of 20.8 WG, the percentiles of estimated fetal weight (EFW) and abdominal circumference (AC) were significantly higher in women who tested positive for GDM at late screening than in women with normal glucose tolerance (NGT). However, while no differences in the birthweight (BW) percentiles of neonates born to non-HR women diagnosed with GDM at 24–28 WG, with respect to NGT women were observed (p=0.416), neonates born to HR women diagnosed with GDM at 24–28 WG (due to refusal to comply with early screening advices) were significantly heavier (p<0.001). In contrast, both the EFW and AC percentiles, as well as the BW percentiles, were significantly lower in infants born to HR women diagnosed with GDM at 16–18 WG with respect to their late diagnosis counterparts (EFW p=0.001, AC p=0.002, BW p=0.048), and not dissimilar to those of NGT women (EFW p=0.824, AC p=0.873, BW p=0.242). These results were confirmed by regression analysis, while adjusting for maternal confounders. Although an initial acceleration of FG related to GDM can be detected at anomaly scan in non-HR women, reversion occurs with current screening recommendations. Earlier screening strategies should be reserved to HR women, as the acceleration of FG related to GDM in these cases is less responsive to treatment delays. (1) Ref: Li et al. Lancet Diabetes Endocrinol. 2020;8(4):292–300.

scholarly journals Screening for Gestational Diabetes during the COVID-19 Pandemic—Current Recommendations and Their Consequences

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 381
Author(s):  
Anca Maria Panaitescu ◽  
Anca Marina Ciobanu ◽  
Maria Popa ◽  
Irina Duta ◽  
Nicolae Gica ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Current Evidence ◽  
Medical Complications ◽  
Perinatal Morbidity ◽  
Short Term ◽  
Screening Programs ◽  
Screening Strategies ◽  
Current Screening

Gestational diabetes mellitus (GDM) is recognized as one of the most common medical complications of pregnancy that can lead to significant short-term and long-term risks for the mother and the fetus if not detected early and treated appropriately. Current evidence suggests that, with the use of appropriate screening programs for GDM, those women diagnosed and treated have reduced perinatal morbidity. It has been implied that, when screening for GDM, there should be uniformity in the testing used and in further management. This paper summarizes and compares current screening strategies proposed by international bodies and discusses application in the context of the COVID-19 pandemic.

scholarly journals Diabetes Gestacional e o Impacto do Actual Rastreio

2015 ◽  
Vol 28 (1) ◽  
pp. 29 ◽  
Author(s):  
Ana Catarina Massa ◽  
Ricardo Rangel ◽  
Manuela Cardoso ◽  
Ana Campos
Keyword(s):  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Age ◽  
Screening Test ◽  
Demographic Data ◽  
Neonatal Outcomes ◽  
Screening Tests ◽  
Postpartum Screening ◽  
Weight Gain During Pregnancy ◽  
Current Screening

<strong>Introduction:</strong> In 2011, a new screening test for gestational diabetes was introduced which allowed an earlier and larger diagnosis with the goal of reducing maternal and perinatal complications. The aim of our study was to evaluate the prevalence of gestational diabetes, compare maternal and perinatal outcomes with the previous and present screening tests and analyze postpartum screening results.<br /><strong>Material and Methods:</strong> Retrospective study of women with singletons and gestational diabetes diagnosed during 2009 (n = 223) and 2012 (n = 237), at Maternidade Dr. Alfredo da Costa, Portugal. Analysis of clinical charts and assessment of demographic data, medical and obstetric history, weight gain during pregnancy, gestational age at diagnosis, treatment regimens, neonatal outcomes and postpartum screening results, followed by comparison of these variables between the years of 2009 and 2012.<br /><strong>Results:</strong> In 2012, there was an increased gestational diabetes prevalence, lower weight gain during pregnancy (p &lt; 0.001), more frequent use of pharmacological therapy (p &lt; 0.001) and more diagnosed cases during first and second trimester (p &lt; 0.001). As for neonatal outcomes, in this group, the medium weight at birth was significantly lower (p = 0.001) with a decrease of newborns great for gestational age (p = 0.002). Postpartum screening rate was similar among both groups but in 2012 there was an increase of normal results and a decrease of impaired fasting glucose.<br /><strong>Discussion:</strong> Tighter criteria of the current screening test resulted in reduction of the majority of gestational diabetes complications but raised new questions.<br /><strong>Conclusion:</strong> The introduction of the current screening test resulted in an increased prevalence, earlier diagnosis and reduction of macrosomia.<br /><strong>Keywords:</strong> Gestational Diabetes; Mass Screening.

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