scholarly journals Clinical Implications of the NICE 2015 Criteria for Gestational Diabetes Mellitus

2018 ◽  
Vol 7 (10) ◽  
pp. 376 ◽  
Author(s):  
Meena Bhatia ◽  
Lucy Mackillop ◽  
Katy Bartlett ◽  
Lise Loerup ◽  
Yvonne Kenworthy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
International Association ◽  
Fasting Blood Glucose ◽  
Large For Gestational Age ◽  
P Value ◽  
Perinatal Complications ◽  
Neonatal Complications ◽  
Iadpsg Criteria

Background: In response to concerns that the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria labeled too many women with gestational diabetes mellitus (GDM) without evidence of clinical or economic benefit, NICE recommended a change in diagnostic criteria in 2015. Aim: To compare diabetes associated maternal and neonatal complications in pregnancies complicated by GDM diagnosed using IADPSG criteria only, to those with GDM diagnosed using both IADPSG and NICE 2015 criteria. GDM screening was risk factor based. Methods: This was a secondary analysis of a trial of women with GDM diagnosed by the IADPSG criteria (fasting blood glucose (BG) ≥ 5.1 mmol/L, 1 h ≥ 10.0 mmol/L and 2 h ≥ 8.5 mmol/L). Outcomes were compared for two groups: NICE + IADPSG defined as those with GDM diagnosed by both the NICE 2015 and IADPSG criteria (fasting BG ≥ 5.6 mmol/L, 2 h ≥ 8.5 mmol/L); and IADPSG-ONLY (fasting BG 5.1 mmol/L to 5.5 mmol/L, and/or 1-hour ≥10.0 mmol/L, and 2 h ≥ 8.5 mmol/L). We were not able to obtain data for women with a 2-h value between BG 7.8–8.4 mmol/L (i.e., NICE-ONLY; NICE 2015 positive and IADPSG negative). All women were treated for GDM using targets of fasting BG < 5.3 mmol/L and 1-h post prandial BG < 7.8 mmol/L respectively. Results: Of 159 women, 65 (40.9%) were NICE + IADPSG and 94 (59.1%) IADPSG-ONLY. Hypoglycaemic medication use was similar in both groups: 52.3% NICE + IADPSG, 46.8% IADPSG-ONLY, OR 1.0 (0.5–1.9). The IADPSG-ONLY group delivered later than the NICE + IADPSG group; 39.0 weeks (sd 1.4) compared to 38.2 weeks (sd 2.5), p value 0.02. Fewer caesarean sections occurred in IADPSG-ONLY group 30.9% vs. 52.3%, OR 0.4 (0.2–0.9). Birthweight, large for gestational age, and other neonatal complications were not significantly different between groups. Conclusions: Gestational diabetes-associated perinatal complications were similar in both groups. The IADPSG criteria detect women with evidence of ongoing hyperglycaemia who may benefit from treatment during pregnancy.

scholarly journals Gestational Diabetes Mellitus: Screening and Outcomes in Southern Italian Pregnant Women

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Carmelo Capula ◽  
Eusebio Chiefari ◽  
Anna Vero ◽  
Biagio Arcidiacono ◽  
Stefania Iiritano ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
High Risk ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
International Association ◽  
Study Groups ◽  
Large For Gestational Age ◽  
Iadpsg Criteria

Recent Italian guidelines exclude women <35 years old, without risk factors for gestational diabetes mellitus (GDM), from screening for GDM. To determine the effectiveness of these measures with respect to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria, we evaluated 2,448 pregnant women retrospectively enrolled in Calabria, southern Italy. GDM was diagnosed following the IADPSG 2010 criteria. Among 538 women <35 years old, without risk factors, who would have not been tested according to the Italian guidelines, we diagnosed GDM in 171 (31.8%) pregnants (7.0% of total pregnants). Diagnosis was made at baseline (55.6%), 1 hour (39.8%), or 2 hours (4.7%) during OGTT. Despite of appropriate treatment, GDM represented a risk factor for cesarean section, polyhydramnios, increased birth weight, admission to neonatal intensive care units, and large for gestational age. These outcomes were similar to those observed in GDM women at high risk for GDM. In conclusion, Italian recommendations failed to identify 7.0% of women with GDM, when compared to IADPSG criteria. The risk for adverse hyperglycaemic-related outcomes is similar in low-risk and high-risk pregnants with GDM. To limit costs of GDM screening, our data suggest to restrict OGTT to two steps (baseline and 1 hour).

MATERNAL GESTATIONAL DIABETES MELLITUS AND OFFSPRING BODY MASS INDEX FROM 1 TO 4 YEARS

2020 ◽  
Vol 26 (6) ◽  
pp. 619-626
Author(s):  
Xiulin Shi ◽  
Dongmei Wang ◽  
Mingzhu Lin ◽  
Weijuan Su ◽  
Liying Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Body Mass ◽  
International Association ◽  
Study Groups ◽  
Z Score ◽  
Birth Registry ◽  
Iadpsg Criteria

Objective: Using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria to diagnose gestational diabetes mellitus (GDM), the association between GDM and offspring body mass index (BMI) gains in early childhood in China remains unclear. We aimed to assess the association between GDM diagnosed by the IADPSG criteria and BMI gain and the risk for overweight/obesity in offspring from 1 to 4 years. Methods: This prospective cohort study was based on the healthcare records data from the Medical Birth Registry in Xiamen, China. We included 10,412 mother-child pairs tested for GDM using IADPSG criteria. Results: A total of 1,786 (17.2%) offspring were exposed to GDM. The offspring exposed to GDM had higher mean BMI Z-score (difference, 0.07; 95% confidence interval [CI], 0.02 to 0.12) and risk for overweight/obesity (odds ratio [OR], 1.22; 95% CI, 1.06 to 1.40) compared to those unexposed to GDM from 1 to 4 years of age. However, after adjustment for maternal pre-pregnancy BMI (Model 2), these associations attenuated towards the null (difference in BMI Z-score, 0.02; 95% CI, −0.03 to 0.07; OR for overweight/obesity, 1.09; 95% CI, 0.95 to 1.25). Conclusion: The associations between GDM diagnosed using IADPSG criteria and BMI Z-score and the risk for overweight/obesity in offspring at the age of 1 to 4 years were largely explained by maternal pre-pregnancy BMI. Reducing the prevalence of childhood overweight and obesity in China should focus on maternal weight status before pregnancy, in addition to glycemia during pregnancy. Abbreviations: BMI = body mass index; CI = confidence interval; GDM = gestational diabetes mellitus; IADPSG = International Association of Diabetes and Pregnancy Study Groups; LGA = large for gestational age; MBRX = Medical Birth Registry in Xiamen; OGTT = oral glucose tolerance test; OR = odds ratio

scholarly journals Comparative analysis of current diagnostic criteria for gestational diabetes mellitus

2012 ◽  
Vol 5 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mariya V Boyadzhieva ◽  
Iliana Atanasova ◽  
Sabina Zacharieva ◽  
Tsvetalina Tankova ◽  
Violeta Dimitrova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
International Association ◽  
Study Groups ◽  
World Health ◽  
Oral Glucose ◽  
Significant Difference ◽  
Iadpsg Criteria

Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% ( P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.

scholarly journals Inflammatory and Adipokine Status from Early to Midpregnancy in Arab Women and Its Associations with Gestational Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sara Al-Musharaf ◽  
Shaun Sabico ◽  
Syed Danish Hussain ◽  
Fatima Al-Tawashi ◽  
Haifa Bandar AlWaily ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
International Association ◽  
Multivariate Logistic Regression Analysis ◽  
Arab Women ◽  
Second Trimester ◽  
Markers Of Inflammation ◽  
Tnf Α ◽  
Iadpsg Criteria

Objective. To examine differences in maternal serum levels of adipokines (adiponectin, leptin, and resistin) and inflammatory markers (tumor necrosis factor-alpha (TNF-α) and interlukin-6 (IL-6)) from early to midpregnancy among Arab women with or without gestational diabetes mellitus (GDM), along with their links to GDM risk. Methods. This is a multicenter prospective study involving 232 Saudi women attending obstetric care. Both circulating adipokine and markers of inflammation were observed at the first (eight to 12 weeks) and second trimesters (24 to 28 weeks). GDM was screened at 24 to 28 weeks using the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Results. Age and body mass index- (BMI-) matched circulating TNF-α was significantly higher in women with GDM in comparison to non-GDM women ( p = 0.01 ). Adiponectin and resistin significantly decreased from the first to second trimester in women without GDM ( p = 0.002 and 0.026, respectively). Leptin presented a significant rise from the first to second trimester in both groups, with a higher increase in women with GDM ( p = 0.013 ). Multivariate logistic regression analysis revealed that TNF-α was significantly correlated with GDM ( p = 0.03 ). However, significance was lost after adjustments for maternal and lifestyle risk factors (OR 23.58 (0.50 to 1119.98), p = 0.11 ). Conclusion. Inflammatory and adipocytokine profiles are altered in Arab women with GDM, TNF-α in particular. Further studies are needed to establish whether maternal inflammatory and adipocytokine profile influence fetal levels in the same manner.

Exercise and Its Effects on Gestational Diabetes Mellitus and Related Parameters

2020 ◽  
Author(s):  
Sheema Yousuf
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
International Association ◽  
Adverse Pregnancy Outcome ◽  
Controlled Study ◽  
P Value ◽  
Oral Glucose ◽  
Adverse Pregnancy

Background: Gestational Diabetes Mellitus (GDM) has now become one of the most common and important complication of pregnancy worldwide. There are conflicting results of various studies regarding the role of exercise in reducing the risk of GDM. Therefore, the aim of this study was to determine the effectiveness of exercise on prevention of gestational diabetes. Methods: It is a randomized controlled study directed in the obstetrics and gynecology outpatient clinic of Pakistan Institute of Medical Sciences (PIMS) hospital Islamabad beginning from 6 June 2016 to 5 December 2016 including 170 pregnant women satisfying the inclusion criteria. Group A received routine antenatal care while Group B included the pregnant women that were advised brisk walk for 30 minutes three days per week. At 24-28 week of pregnancy, 75gm oral glucose tolerance test (OGTT) was performed and International association for Diabetes in Pregnancy Study Group (IADPSG) and Hyperglycemia and adverse pregnancy outcome (HAPO) standards, determined GDM. Chi Square was applied for comparing GDM frequency and p value ≤0.05 was considered as significant. Results: The mean age of the patients was 28.08 ± 4.15 years and mean gestation of pregnancy was 17.18 ± 0.78 weeks. Gestational diabetes was seen in 08 (9.41%) patients of non-exercising group while in exercise group only 01 (1.18%) patient had GDM (p-value 0.016). Conclusion: Moderate exercise during pregnancy decreases the risk of gestational diabetes mellitus and is safe for the mother and the baby. However, more studies are needed to establish recommendations.

scholarly journals Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min Zhao ◽  
Shuyu Yang ◽  
Tzu Chieh Hung ◽  
Wenjie Zheng ◽  
Xiaojie Su
Keyword(s):  
Diabetes Mellitus ◽  
Folic Acid ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
International Association ◽  
White Cell Count ◽  
Increased Risk ◽  
Iadpsg Criteria ◽  
Laboratory Biomarkers

AbstractGestational diabetes mellitus (GDM) has aroused wide public concern, as it affects approximately 1.8–25.1% of pregnancies worldwide. This study aimed to examine the association of pre-pregnancy demographic parameters and early-pregnancy laboratory biomarkers with later GDM risk, and further to establish a nomogram prediction model. This study is based on the big obstetric data from 10 “AAA” hospitals in Xiamen. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Data are analyzed using Stata (v14.1) and R (v3.5.2). Total 187,432 gestational women free of pre-pregnancy diabetes mellitus were eligible for analysis, including 49,611 women with GDM and 137,821 women without GDM. Irrespective of confounding adjustment, eight independent factors were consistently and significantly associated with GDM, including pre-pregnancy body mass index (BMI), pre-pregnancy intake of folic acid, white cell count, platelet count, alanine transaminase, albumin, direct bilirubin, and creatinine (p < 0.001). Notably, per 3 kg/m2 increment in pre-pregnancy BMI was associated with 22% increased risk [adjusted odds ratio (OR) 1.22, 95% confidence interval (CI) 1.21–1.24, p < 0.001], and pre-pregnancy intake of folic acid can reduce GDM risk by 27% (adjusted OR 0.73, 95% CI 0.69–0.79, p < 0.001). The eight significant factors exhibited decent prediction performance as reflected by calibration and discrimination statistics and decision curve analysis. To enhance clinical application, a nomogram model was established by incorporating age and above eight factors, and importantly this model had a prediction accuracy of 87%. Taken together, eight independent pre-/early-pregnancy predictors were identified in significant association with later GDM risk, and importantly a nomogram modeling these predictors has over 85% accuracy in early detecting pregnant women who will progress to GDM later.

scholarly journals Prevalence of gestational diabetes mellitus using IADPSG and DIPSI criteria: a cross-sectional study

2020 ◽  
Vol 9 (6) ◽  
pp. 2408
Author(s):  
Trupti C. Ruge ◽  
Nisha Kanchana
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
International Association ◽  
Clinical Equipoise ◽  
Kappa Statistics ◽  
Diabetes In Pregnancy ◽  
Cross Sectional ◽  
Iadpsg Criteria ◽  
In Pregnancy

Background: Considering the magnitude of adverse pregnancy outcomes related to gestational diabetes, the present study was undertaken to find out the prevalence of gestational diabetes mellitus using the international association of diabetes in pregnancy study groups criteria (IADPSG) and diabetes in pregnancy study group India (DIPSI) criteria to ascertain whether the present practice of diagnosing GDM by the guidelines recommended by DIPSI 21 based on WHO criterion of 2-h PG ≥140 mg/dL can still be followed in this study settings or adopt IADPSG recommendation.Methods: This study was done at Antenatal Clinic, department of obstetrics and gynecology, KLES Dr Prabhakar Kore Hospital, Belgaum from January 2013 to December 2013. A total of 225 pregnant women between 24 to 28 weeks gestations were studied. Diagnosis and the prevalence of GDM were assessed by applying both DIPSI and IADPSG criteria.Results: Most of the women (58.11%) were between 22 to 25 years and the mean age was 23.78±3.38 years. Based on the IADPSG criteria, the prevalence of GDM was 19.11% and by applying DIPSI criteria, prevalence of GDM was 16.89%. The difference in diagnostic capability between IADPSG and DIPSI was found to be 2.8% and the kappa statistics showed good strength of agreement between the two tests (p>0.302; Kappa=0.774).Conclusions: It was concluded that, the diagnosis GDM based on DIPSI is as effective as IADPSG criteria. Further, in resource poor countries like India, DIPSI procedure would be used with an advantage of being less costly and without compromising the clinical equipoise. 

Sign in / Sign up

Export Citation Format

Share Document