Diagnostic thresholds for gestational diabetes and their impact on pregnancy outcomes: a systematic review

Abstract

Higher glucose thresholds did not consistently demonstrate greater risk, possibly because studies did not compare mutually exclusive groups of women. A pragmatic approach for diagnosis of gestational diabetes using Hyperglycemia and Adverse Pregnancy Outcome Study odds ratio 2.0 thresholds warrants further consideration until additional analysis of the data comparing mutually exclusive groups of women is provided and large randomized controlled trials investigating different diagnostic and treatment thresholds are completed.

Screening for dysglycaemia during pregnancy: Proposals conciliating International Association of Diabetes and Pregnancy Study Group (IADPSG) and US National Institutes of Health (NIH) panels

“…However, measurements should be repeated if they are close to the abnormal threshold after 24 weeks of gestation -in other words, ≥ 95 mg/dL (5.3 mmol/L) -to confirm the diagnosis. We encourage other groups to either propose alternative strategies [21] or support our proposition [33], and the worldwide community to declare an acceptable unique standard for GDM diagnosis. Finally, screening for dysglycaemia during pregnancy should be considered an available tool for improving pregnancy outcomes.…”

Gestational diabetes mellitus prevalence: Effect of the laboratory analytical variation

“…d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e x x x ( 2 0 1 5 ) x x x -x x x diabetes mellitus and the criteria used for diagnosis [2,3]. Since there is a general erroneous perception that the quality of all medical laboratories is similar, laboratory results are not implicated for the variation in GDM prevalence [4].…”

“…A diagnosis of GDM is confirmed by the oral glucose tolerance test (OGTT) with various health organizations recommending different glucose thresholds for diagnosis; as a result, many international diagnostic criteria are available for diagnosis. Depending on which one of these diagnostic criteria is used and the ethnicity of the population, the prevalence of GDM varies widely from 1.1 to 25.5% [3]. Generally, the laboratory quality (reflected by the glucose analytic variability) is not implicated as a cause for the variation of GDM prevalence.…”

Birth weight classification in gestational diabetes: is there an ideal chart?

“…Recent meta-analyses described an increased rate of LGA and macrosomia for GDM women 9,10 , which can be decreased by treatment 11 without increasing small for gestational age (SGA) rates 11,12 . In this paper, our first objective was to plot a curve based on data from a large national registry of 2012, the Born Alive National Surveillance System (Sistema de Informações de Nascidos Vivos -SINASC) 13 , creating the SINASC-2012 chart.…”