Influence of new criteria for the diagnosis of gestational diabetes mellitus on its expected frequency of occurrence and complications
Journal Title: Ginekologia i Położnictwo medical project - Year 2015, Vol 4, Issue 38
Abstract
Gestational diabetes mellitus (GDM) is the most common glucose tolerance disorder diagnosed during pregnancy. It is associated with complications for the mother, fetus and the child in the future. A prospective multicenter study, called HAPO, demonstrated a linear relationship between glycemia in OGTT in pregnant patients and macrosomia, the frequency of cesarean sections, the level of c-peptide in the umbilical blood and neonatal hypoglycemia. Based on its results, the International Association of Diabetes and Pregnancy Study Group (IADPSG) and the World Health Organization (WHO) have proposed new criteria for GDM diagnosis. The Polish Gynecologic Society (Polskie Towarzystwo Ginekologiczne, PTG) accepted them in 2014. According to the previous criteria, a fasting glucose level ranged from 95 to 126 mg/dl and increased to 140 mg/dl after 2 hours (ADA criteria from 2004, WHO from 1999 and PTG from 2011) [1–3]. Due to lower fasting glucose limit values in a OGTT test (to 92 mg/dl) and increased level after 2 hours (up to 153 mg/dl), a question arises concerning the influence of these new criteria on the frequency of GDM and complications during pregnancy and in the fetus (4–6). A considerable number of studies conducted so far indicate an increase in diagnoses of gestational diabetes mellitus compared with the previous criteria. It is also suggested that the number of labor inductions and cesarean sections has also increased. It is estimated that the treatment of mild hyperglycemia would reduce the percentage of macrosomia, shoulder dystocia and the need for hospitalization of newborns at neonatal intensive care units [7]. It is still postulated that the new criteria should be verified in large, prospective randomized trials.
Authors and Affiliations
Luiza Oleszczuk-Modzelewska, Krzysztof Czajkowski
Keywords
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- EP ID EP580662
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