Application of One-Step IADPSG Versus Two-Step Diagnostic Criteria for Gestational Diabetes in the Real World: Impact on Health Services, Clinical Care, and Outcomes

Abstract

Purpose of ReviewThis paper seeks to summarize the impact of the one-step International Association of Diabetes and Pregnancy Study Groups (IADPSG) versus the two-step gestational diabetes mellitus (GDM) criteria with regard to prevalence, outcomes, healthcare delivery, and long-term maternal metabolic risk.Recent FindingsStudies demonstrate a 1.03–3.78-fold rise in the prevalence of GDM with IADPSG criteria versus baseline criteria. Women with GDM by IADPSG criteria have more adverse pregnancy outcomes than women with normal glucose tolerance (NGT). Treatment of GDM by IADPSG criteria may be cost effective. Use of the fasting glucose as a screen before the 75-g oral glucose tolerance test to rule out GDM with fasting plasma glucose (FPG) < 4.4 (80 mg/dl) and rule in GDM with FPG ≥ 5.1 mmol/l (92 mg/dl) reduces the need for OGTT by 50% and its cost and inconvenience. The prevalence of postpartum abnormal glucose metabolism is higher for women with GDM diagnosed by IADPSG criteria versus that for women with NGT.SummaryData support the use of IADPSG criteria, if the cost of diagnosis and treatment can be controlled and if lifestyle can be optimized to reduce the risk of future diabetes.

Serum Adropin and Adipose Fatty-Acid Binding Protein at 6th Week of Pregnancy Are Significant Predictors for Development of Insulin Resistance at the 24th Week.

“…The reported figure for frequency of GDM goes in hand with Ma et al (30) , Karcaaltincaba et al (31) and Arbib et al (32) who reported frequencies of 12.2%, 11.1% and 9.9%, respectively for GDM. Moreover, Huhn et al (33) and Brown & Wyckoff (34) documented that the introduction of the IADPSG criteria resulted in an absolute increase of GDM prevalence of 8.5% (33) and a 1.03-3.78-fold rise versus baseline criteria (34) .…”

Dietary Protein Intake, Meat Consumption, and Dairy Consumption in the Year Preceding Pregnancy and During Pregnancy and Their Associations With the Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study in Southwest China

“…For offspring, GDM pregnancy confers a greater risk of developing obesity, diabetes, hypertension, cardiovascular disease in youth, and adult life ( 6 , 7 ). According to the diagnostic criteria of 2011 issued by the Ministry of Health (MOH) China ( 8 ), which endorsed the new criteria by the IADPSG ( 1 ), the prevalence of GDM in China is 17.5% in 2013 ( 9 ), which is higher than the prevalence in Europe and the USA ( 10 , 11 ). Given the substantial relevance of GDM for medium and long-term health of both mother and offspring, it is crucial to identify modifiable risk factors which contribute to GDM prevention among Chinese population.…”

Prevalencia de Diabetes Mellitus Gestacional por curva de tolerancia a la glucosa en semanas 24 a 28. Cohorte prospectiva en Armenia Colombia, 2015-2016

“…El diagnóstico de DMG ha sido tradicionalmente tema de controversia (39). La prevalencia del diagnóstico de DMG se ha incrementado con la difusión de los criterios de la IADPSG (40). En la revisión de la literatura, Brown et al reportan una prevalencia de DMG que varía entre 3,5 y 45,3 %.…”