Gestational diabetes

Benhalima, Katrien; Mathieu, Chantal

doi:10.1097/gco.0000000000000028

Cited by 7 publications

(3 citation statements)

References 40 publications

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“…Using the current screening methods and thresholds in Sweden, this study confirmed this level of GDM. Clearly, the “true level” of GDM within a specific setting depends on screening method (universal/general), the criterion for diagnosis of GDM [22], coverage of OGTT in the targeted population, the OGTT 2-hour cut-off value, and background characteristics of the pregnant population [23]. …”

Section: Discussionmentioning

confidence: 99%

No consensus on gestational diabetes mellitus screening regimes in Sweden: pregnancy outcomes in relation to different screening regimes 2011 to 2012, a cross-sectional study

Lindqvist

Persson

Lindkvist

et al. 2014

BMC Pregnancy Childbirth

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BackgroundAlthough associated adverse pregnancy outcomes, no international or Swedish consensus exists that identifies a cut-off value or what screening method to use for definition of gestational diabetes mellitus. This study investigates the following: i) guidelines for screening of GDM; ii) background and risk factors for GDM and selection to OGTT; and iii) pregnancy outcomes in relation to GDM, screening regimes and levels of OGTT 2 hour glucose values.MethodsThis cross-sectional and population-based study uses data from the Swedish Maternal Health Care Register (MHCR) (2011 and 2012) combined with guidelines for GDM screening (2011–2012) from each Maternal Health Care Area (MHCA) in Sweden. The sample consisted of 184,183 women: 88,140 in 2011 and 96,043 in 2012. Chi-square and two independent samples t-tests were used. Univariate and multivariate logistic regression analyses were performed.ResultsFour screening regimes of oral glucose tolerance test (OGTT) (75 g of glucose) were used: A) universal screening with a 2-hour cut-off value of 10.0 mmol/L; B) selective screening with a 2-hour cut-off value of 8.9 mmol/L; C) selective screening with a 2-hour cut-off value of 10.0 mmol/L; and D) selective screening with a 2-hour cut-off value of 12.2 mmol/L. The highest prevalence of GDM (2.9%) was found with a 2-hour cut-off value of 8.9 mmol/L when selective screening was applied. Unemployment and low educational level were associated with an increased risk of GDM. The OR was 4.14 (CI 95%: 3.81-4.50) for GDM in obese women compared to women with BMI <30 kg/m2. Women with non-Nordic origin presented a more than doubled risk for GDM compared to women with Nordic origin (OR = 2.24; CI 95%: 2.06-2.43). Increasing OGTT values were associated with increasing risks of adverse pregnancy outcomes.ConclusionsThere was no consensus regarding screening regimes for GDM from 2011 through 2012 when four different regimes were applied in Sweden. Increasing levels of OGTT 2-hour glucose values were strongly associated with adverse pregnancy outcomes. Based on these findings, we suggest that Sweden adopts the recent recommendations of the International Association of Diabetes and Pregnancy Study Group (IADPSG) concerning the performance of OGTT and the diagnostic criteria for GDM.

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Section: Discussionmentioning

confidence: 99%

No consensus on gestational diabetes mellitus screening regimes in Sweden: pregnancy outcomes in relation to different screening regimes 2011 to 2012, a cross-sectional study

Lindqvist

Persson

Lindkvist

et al. 2014

BMC Pregnancy Childbirth

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“…The fasting plasma glucose, insulin level, and HOMA-IR after six weeks of intervention decreased significantly compared to the control group. In that study, GDM diagnosis was based on 75-g glucose OGTT (the new ADA criteria), whereas in our study, 84% of the recruited patients were diagnosed by 100-g glucose OGTT, which detects severe cases of GDM ( 27 ). Another difference is that in Asemi et al study, patients requiring insulin therapy during pregnancy were excluded, whereas in our study, 90% of the patients in group I and 83% in group C required insulin for glycemic control.…”

Section: Discussionmentioning

confidence: 79%

The Impact of Vitamin D Supplementation on Post-Partum Glucose Tolerance and Insulin Resistance in Gestational Diabetes: A Randomized Controlled Trial

Piri

Mohammadian

Kamali

et al. 2016

Int J Endocrinol Metab

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BackgroundHypovitaminosis D has been associated with the development of gestational diabetes mellitus (GDM) in many observational studies.ObjectivesWe report the first study of the impact of prenatal vitamin D supplementation on postpartum dysglycemia in GDM patients in a randomized clinical trial.Patients and MethodsWomen with GDM at 12 - 32 weeks of gestation were assigned randomly to either the intervention group (in which serum 25-hydroxy vitamin D [25OHD] levels were measured immediately, n = 48) or the control group (in which the serum was stored and assayed at 6 - 12 weeks post-partum, n = 48). Participants with initial serum 25OHD < 30 ng/mL in the intervention group were instructed to take a total of 700,000 IU vitamin D3 during pregnancy. The primary outcomes were fasting plasma glucose (FPG), insulin, 2-h post 75 g glucose load plasma glucose (2-hPLG), homeostasis model assessment of insulin resistance (HOMA-IR), HbA1C, and 25 OHD at 6 - 12 weeks after delivery.ResultsThe mean ± SD of serum 25OHD in the intervention group raised dramatically from 14.6 ± 6.3 to 32.4 ± 14.4 ng/mL, whereas no significant change occurred in the control group (from 17.7 ± 6.1 to 19.3 ± 9.6 ng/mL, P < 0.001). Thirteen participants developed dysglycemia in each group. Mean FPG, 2-hPLG, and HOMA-IR were not significantly different between the groups. There was no significant difference between the groups for maternal and neonatal outcomes.ConclusionsAlthough the high vitamin D supplementation dose in the present study (compared to the 400 IU/day dose usually recommended for pregnancy) safely increases the serum 25OHD, in GDM cases, the higher dose does not affect the plasma glucose level or insulin resistance at short term follow-up after delivery.

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“…It is difficult to compare the prevalence of gestational diabetes mellitus (GDM) in different countries because screening and diagnosis vary widely [3]. A frequently used screening protocol is a two-step procedure including a 50 g glucose screening test (O'Sullivan) followed by a 3-h 100 g oral glu-cose tolerance test (OGTT) if the initial test is positive (Carpenter and Coustan criteria) [4,5].…”

Section: Introductionmentioning

confidence: 99%

Consequences of the Adoption of the IADPSG versus Carpenter and Coustan Criteria to Diagnose Gestational Diabetes: A Before-After Comparison

Gariani

Egloff

Prati

et al. 2018

Exp Clin Endocrinol Diabetes

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Aims To evaluate if the adoption of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria for Gestational Diabetes Mellitus (GDM) led to changes in the management and in the occurrence of pregnancy complications. Methods This was a retrospective study of women with GDM followed at a single university center, diagnosed in 2009–2010 using the Carpenter and Coustan criteria (period 1) and in 2012–2013 using the IADPSG criteria (period 2). Results We included 286 women with GDM, 129 in period 1 and 157 in period 2. Age, body mass index and weight gain during pregnancy were similar. There were less women requiring insulin therapy in period 2 than in period 1 (43.3% versus 55.0% respectively, p=0.048), but no significant difference in the number of cesarean section, in babies born large for gestational age and in the occurrence of preeclampsia. There was less neonatal hypoglycemia (<2.5 mmol/l) in period 2 versus period 1 (7 versus 23 neonates respectively, p<0.001). Conclusions When using the new IADPSG criteria, women with a less severe GDM are diagnosed, and fewer women require insulin. There was no difference in maternal outcomes, but less neonatal hypoglycemia during when using the IADPSG criteria.

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Gestational diabetes

Cited by 7 publications

References 40 publications

No consensus on gestational diabetes mellitus screening regimes in Sweden: pregnancy outcomes in relation to different screening regimes 2011 to 2012, a cross-sectional study

No consensus on gestational diabetes mellitus screening regimes in Sweden: pregnancy outcomes in relation to different screening regimes 2011 to 2012, a cross-sectional study

The Impact of Vitamin D Supplementation on Post-Partum Glucose Tolerance and Insulin Resistance in Gestational Diabetes: A Randomized Controlled Trial

Consequences of the Adoption of the IADPSG versus Carpenter and Coustan Criteria to Diagnose Gestational Diabetes: A Before-After Comparison

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