Evolution of Screening and Diagnostic Criteria for GDM Worldwide

Agarwal, Mukesh

doi:10.1007/978-1-84882-120-0_3

Cited by 10 publications

(7 citation statements)

References 49 publications

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“…The current guidelines for GDM have numerous shortcomings: they have often been developed from tenuous data, frequently the result of expert opinion, sometimes economically driven, and at times convenience oriented (1). Finally, the long-awaited, single-guideline—based on sound scientific data—is available.…”

Section: Discussionmentioning

confidence: 99%

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Gestational Diabetes Mellitus

2010

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OBJECTIVETo determine the impact of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria on 1) gestational diabetes mellitus (GDM) diagnosis compared with the American Diabetes Association (ADA) criteria and 2) the fasting plasma glucose (FPG) to predict GDM.RESEARCH DESIGN AND METHODSIn 10,283 pregnant women undergoing a 75-g oral glucose tolerance test (OGTT) for universal screening of GDM, two FPG thresholds (of the OGTT) were used to rule in and to rule out GDM.RESULTSThe IADPSG and ADA criteria identified GDM in 3,875 (37.7%) women and 1,328 (12.9%) women, respectively (P < 0.0005). FPG thresholds of ≥5.1 mmol/l ruled in GDM in 2,975 (28.9%) women with 100% specificity, while <4.4 mmol/l ruled out GDM in 2,228 (21.7%) women with 95.4% sensitivity. FPG independently could have avoided the OGTT in 5,203 (50.6%) women.CONCLUSIONSThe IADPSG criteria increased GDM prevalence nearly threefold. By circumventing a significant number of OGTTs, an initial FPG can greatly simplify the IADPSG diagnostic algorithm.

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Section: Discussionmentioning

confidence: 99%

“…The scourge of gestational diabetes mellitus (GDM) is the lack of an international agreement on the screening and diagnosis among the pre-eminent diabetes, obstetric, and health care organizations (1). Therefore, without a globally accepted guideline, the diagnosis of GDM causes a great deal of clinical confusion (2).…”

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confidence: 99%

Gestational Diabetes Mellitus

2010

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“…However, due to an array of recommendations available, the screening and diagnosis of GDM remain contentious. Often, the obstetric and endocrine associations within the same country support markedly dissimilar protocols for GDM, leading to major inconsistencies in the approach to GDM globally. In 2010, the International Association of Diabetes and Pregnancy Study Groups (IADPSG) proposed a unified approach for screening and diagnosis of GDM advocating the 2‐h, 75‐g OGTT for all pregnant women at 24–28 weeks .…”

Section: Introductionmentioning

confidence: 99%

Gestational diabetes mellitus: Confusion among medical doctors caused by multiple international criteria

Agarwal

Shah

Kaabi

et al. 2014

J of Obstet and Gynaecol

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“…Despite 4 decades of research, the screening and diagnosis of gestational diabetes mellitus (GDM) have remained controversial. The different international obstetric, health, and endocrine associations often support markedly disparate schemes for GDM, resulting in an array of algorithms [1]. To unify this diversity, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) proposed a one-step approach for GDM worldwide [2].…”

Section: Introductionmentioning

confidence: 99%

Gestational diabetes screening: The low‐cost algorithm

Agarwal

Weigl

Hod

2011

Intl J Gynecology & Obste

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The American Diabetes Association has endorsed the demanding recommendation by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) that every pregnant woman should undergo the oral glucose tolerance test (OGTT) for the screening of gestational diabetes mellitus (GDM). The aim of this study was to find out if the fasting plasma glucose (FPG) and newer emerging technologies could simplify the cumbersome IADPSG algorithm. Two FPG thresholds (of the OGTT) were used to rule in and rule out GDM in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort (n = 23316) and a population at high risk for GDM (n = 10283). For the HAPO cohort and the high-risk population, respectively, FPG thresholds of: (a) ≥ 5.1 mmol/L (specificity 100%) independently ruled in GDM in 1769 (8.3%) women and 2975 (28.9%) women; and (b) ≤ 4.4 mmol/L ruled out GDM in 11526 (49.4%) women (84.1% sensitivity) and 2228 (21.7%) women (95.4% sensitivity). Use of the FPG independently could have avoided 13295 (57.0%) and 5203 (50.6%) OGTTs in the 2 groups. The initial FPG-by significantly reducing the number of cumbersome OGTTs needed-can make the IADPSG recommendations more acceptable worldwide. The number of GDM women missed is population dependent. For low-resource countries, alternative newer and cheaper tests in development hold an exciting future.

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Evolution of Screening and Diagnostic Criteria for GDM Worldwide

Cited by 10 publications

References 49 publications

Gestational Diabetes Mellitus

Gestational Diabetes Mellitus

Gestational diabetes mellitus: Confusion among medical doctors caused by multiple international criteria

Gestational diabetes screening: The low‐cost algorithm

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