Comparing Different Diagnostic Guidelines for Gestational Diabetes Mellitus in Relation to Birthweight in Sri Lankan Women

Abstract

Introduction: While the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria is widely adopted in many countries, clinicians have questioned the applicability of these diagnostic thresholds for different races/ethnicities. We first compared the prevalence of gestational diabetes mellitus (GDM) diagnosed with different criteria including IADPSG, World Health Organization (WHO) 1999 and Sri Lankan national guidelines, and subsequently related individual guidelines-specific GDM prevalence to offspring birthweight in Sri Lanka.Materials and Methods: We retrospectively collected data on singleton pregnancies (n = 795) from two tertiary hospitals in Sri Lanka. We applied three diagnostic guidelines to define GDM, namely IADPSG criteria, the Sri Lankan national and WHO 1999 guidelines. We calculated the age- and first booking BMI-adjusted prevalence rates of GDM and assessed the association of GDM (using each guideline) with birthweight.Results: The age- and first booking BMI-adjusted GDM prevalence rates were 31.2, 28.0, and 13.1% for IADPSG criteria, Sri Lankan national and WHO 1999 guidelines, respectively. The IADPSG criteria identified 90 distinctive GDM cases at a lower cut-off of fasting glucose (from 5.1 to 5.5 mmol/L) while Sri Lankan national guideline identified 15 distinctive GDM cases at a lower cut-off for 2-h glucose (from 7.8 to 8.4 mmol/L). After adjusting for age, GDM diagnosed by IADPSG criteria was associated with higher birthweight [90.8 g, 95% CI: 10.8, 170.9], while the associations for GDM diagnosed either by Sri Lankan national or WHO 1999 guidelines were not significant.Conclusion: Adopting the IADPSG criteria for diagnosing GDM may be important in Sri Lankan pregnant population.

Evolution of Gestational Diabetes Mellitus across Continents in 21st Century

“…Positive results were noted in 13.9% of the participants [ 217 ]. After adopting the IADPSG criteria to diagnose GDM, the total prevalence of the disease was 31.2% [ 218 ].…”

Exploring abnormal glucose metabolism in pregnancy among Australian Chinese migrants

“…The current investigation is a substudy of the Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children-International (IPRAMHO-International) Collaborative Study. This study is built on the IPRAMHO Asia-Pacific study group, which provides a platform for clinicians from countries in the Asia-Pacific region to share their experience or clinical practices of screening, diagnosing and treating GDM during pregnancy and after delivery 26 27. We obtained delivery electronic records from a total of 6851 singleton pregnancies born in one calendar year in Australia and 1000 singleton pregnancies in China.…”

Exploring the effectiveness of various screening criteria used in gestational diabetes mellitus

“…Dias et al compared the different diagnostic guidelines (IADPSG, WHO and Sri Lankan national guidelines) for GDM in relationship to birth-weight in Sri-Lankan Women. 13 They included 795 singleton pregnancies from two tertiary hospitals in Sri Lanka. They concluded that from their results, that IADPSG criteria is superior over WHO and Sri Lankan national guidelines among their study population.…”