A Modified Two-Step Screening Strategy for Gestational Diabetes Mellitus Based on the 2013 WHO Criteria by Combining the Glucose Challenge Test and Clinical Risk Factors

Benhalima, Katrien; Crombrugge, Paul Van; Moyson, Carolien; Verhaeghe, Johan; Vandeginste, Sofie; Verlaenen, Hilde; Vercammen, Chris; Maes, Toon; Dufraimont, Els; Block, Christophe De; Jacquemyn, Yves; Mekahli, Farah; Clippel, Katrien De; Bruel, Annick Van den; Loccufier, Anne; Laenen, Annouschka; Minschart, Caro; Devlieger, Roland; Mathieu, Chantal

doi:10.3390/jcm7100351

Cited by 41 publications

(37 citation statements)

References 33 publications

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“…In a study by Katrien Benhalima et al, the modified 2 step screening strategy with GCT and clinical risk factors improved the diagnostic accuracy. 10,11 As proved by earlier studies, in our study also the prevalence of GDM is 8.1% and majority of GDM patients were of age group 26-30 yrs. 58.3% of GDM cases were multi gravidae.…”

Section: Discussionsupporting

confidence: 79%

Screening for gestational diabetes mellitus by two step method and the pregnancy outcome: a study in Indian women

Srinivasan

Palanisamy

2019

Int J Reprod Contracept Obstet Gynecol

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Background: In recent times, gestational diabetes is becoming more common Worldwide and complications are seen in fetal development, growth, labour and delivery due to maternal hyperglycemia. Gestational Diabetes Mellitus(GDM) is associated with adverse maternal and fetal outcomes. Among South Asian Population, Indian Women are at high risk of developing carbohydrate intolerance during pregnancy. Hence this study is undertaken to screen for gestational diabetes mellitus by two step method in Indian Women.Methods: This study was done in 153 nondiabetic pregnant women of gestational age 24-28 weeks, excluding diabetes mellitus diagnosed prior to pregnancy. Two step method was followed in the present study and GDM was diagnosed and the pregnancy outcomes were noted.Results: In our study the prevalence of GDM is 8.1% by two step method. Most of the women diagnosed with GDM were of age 26-30 yrs (41.66%). Among the women who were diagnosed as GDM, (58.33%) cases required Insulin along with diet control. In our study 33.33% had vaginal delivery, 8.33% had Emergency LSCS and 58.33% had Elective LSCS.Conclusion: Indian Women have high prevalence of GDM, hence universal screening is essential to diagnose GDM, which will improve the pregnancy outcome.

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Section: Discussionsupporting

confidence: 79%

Screening for gestational diabetes mellitus by two step method and the pregnancy outcome: a study in Indian women

Srinivasan

Palanisamy

2019

Int J Reprod Contracept Obstet Gynecol

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“…The Belgian Diabetes in Pregnancy Study (BEDIP-N) was a multicentre prospective cohort study that has previously been described in detail [6][7][8]. The study protocol was approved by the institutional review boards of all participating centres.…”

Section: Methodsmentioning

confidence: 99%

“…Of all the BEDIP-N participants, 1813 (90.3%) received both a GCT and an OGTT between 24 and 28 weeks of pregnancy, with 228 women diagnosed with GDM (prevalence of 12.4%). Overall, 106 participants (5.3%) discontinued the study before 24 weeks of pregnancy, half because of a medical reason [8]. We have recently shown that the threshold of the GCT would need to be reduced to at least 7.2 mmol/l to achieve sensitivity of ≥70% for GDM based on the 2013 WHO criteria [7].…”

Section: Methodsmentioning

confidence: 99%

Characteristics and pregnancy outcomes across gestational diabetes mellitus subtypes based on insulin resistance

et al. 2019

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Aims/hypothesis This study aimed to determine the characteristics and pregnancy outcomes across different subtypes of gestational diabetes mellitus (GDM) based on insulin resistance. Methods GDM subtypes were defined in 1813 pregnant women from a multicentre prospective cohort study, stratified according to insulin resistance, based on Matsuda index below the 50th percentile of women with normal glucose tolerance (NGT), during a 75 g OGTT at 24-28 weeks' gestation. GDM was diagnosed in 12.4% (n = 228) of all participants based on the 2013 WHO criteria. Results Compared with women with NGT (1113 [61.4%] of the total cohort) and insulin-sensitive women with GDM (39 [17.1%] women with GDM), women with GDM and high insulin resistance (189 [82.9%] women with GDM) had a significantly higher BMI, systolic BP, fasting plasma glucose (FPG), fasting total cholesterol, LDL-cholesterol and triacylglycerol levels in early pregnancy. Compared with women with NGT, insulin-sensitive women with GDM had a significantly lower BMI but similar BP, FPG and fasting lipid levels in early pregnancy. Compared with women with NGT, women with GDM and high insulin resistance had higher rates of preterm delivery (8.5% vs 4.7%, p = 0.030), labour induction (42.7% vs 28.1%, p < 0.001), Caesarean section (total Caesarean sections: 28.7% vs 19.4%, p = 0.004; emergency Caesarean sections: 16.0% vs 9.7%, p = 0.010), neonatal hypoglycaemia (15.4% vs 3.5%, p < 0.001) and neonatal intensive care unit admissions (16.0% vs 8.9%, p = 0.003). In multivariable logistic regression analyses using different models to adjust for demographics, BMI, FPG, HbA 1c , lipid levels and gestational weight gain in early pregnancy, preterm delivery (OR 2.41 [95% CI 1.08, 5.38]) and neonatal

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“…The Belgian Diabetes in Pregnancy study (BEDIP-N) was a multi-centric prospective cohort study that has previously been described in detail [13,14,15]. Women between 18–45 years with singleton pregnancies, and without history of diabetes or bariatric surgery, were recruited between 6–14 weeks of pregnancy [13].…”

Section: Methodsmentioning

confidence: 99%

Prediction of Glucose Intolerance in Early Postpartum in Women with Gestational Diabetes Mellitus Based on the 2013 WHO Criteria

Benhalima

Crombrugge

Moyson

et al. 2019

JCM

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Predictors for glucose intolerance postpartum were evaluated in women with gestational diabetes mellitus (GDM) based on the 2013 World Health Organization (WHO) criteria. 1841 women were tested for GDM in a prospective cohort study. A postpartum 75g oral glucose tolerance test (OGTT) was performed in women with GDM at 14 ± 4.1 weeks. Of all 231 mothers with GDM, 83.1% (192) had a postpartum OGTT of which 18.2% (35) had glucose intolerance. Women with glucose intolerance were more often of Asian origin [15.1% vs. 3.7%, OR 4.64 (1.26–17.12)], had more often a recurrent history of GDM [41.7% vs. 26.7%, OR 3.68 (1.37–9.87)], higher fasting glycaemia (FPG) [5.1 (4.5–5.3) vs. 4.6 (4.3–5.1) mmol/L, OR 1.05 (1.01–1.09)], higher HbA1c [33 (31–36) vs. 32 (30–33) mmol/mol, OR 4.89 (1.61–14.82)], and higher triglycerides [2.2 (1.9–2.8) vs. 2.0 (1.6–2.5) mmol/L, OR 1.00 (1.00–1.01)]. Sensitivity of glucose challenge test (GCT) ≥7.2 mmol/l for glucose intolerance postpartum was 80% (63.1%–91.6%). The area under the curve to predict glucose intolerance was 0.76 (0.65–0.87) for FPG, 0.54 (0.43–0.65) for HbA1c and 0.75 (0.64–0.86) for both combined. In conclusion, nearly one-fifth of women with GDM have glucose intolerance postpartum. A GCT ≥7.2 mmol/L identifies a high risk population for glucose intolerance postpartum.

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A Modified Two-Step Screening Strategy for Gestational Diabetes Mellitus Based on the 2013 WHO Criteria by Combining the Glucose Challenge Test and Clinical Risk Factors

Cited by 41 publications

References 33 publications

Screening for gestational diabetes mellitus by two step method and the pregnancy outcome: a study in Indian women

Screening for gestational diabetes mellitus by two step method and the pregnancy outcome: a study in Indian women

Characteristics and pregnancy outcomes across gestational diabetes mellitus subtypes based on insulin resistance

Prediction of Glucose Intolerance in Early Postpartum in Women with Gestational Diabetes Mellitus Based on the 2013 WHO Criteria

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