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

Cosson, E.; Valensi, P.; Carbillon, Lionel

doi:10.1016/j.diabet.2014.08.001

Cited by 11 publications

(8 citation statements)

References 34 publications

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“…In summary, we have confirmed a clear weakness in some recommendations proposing that FPG in the 5.1-6.9 mmol/l range should be considered for diagnosis of hyperglycaemia at any time during pregnancy [11,12,27]. We show that women with eFHG without risk factors are very unlikely to develop further GDM.…”

Section: Prediction Of Incident Gdm In Women With Untreated Efhgsupporting

confidence: 64%

Initially untreated fasting hyperglycaemia in early pregnancy: prognosis according to occurrence of gestational diabetes mellitus after 22 weeks’ gestation: a case–control study

et al. 2019

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Aims To evaluate the percentage of women with untreated fasting hyperglycaemia in early pregnancy who develop gestational diabetes mellitus after 22 weeks’ gestation, the determinants of gestational diabetes development in such women and the prognosis of early fasting hyperglycaemia according to whether the women go on to develop gestational diabetes. Methods From a large cohort of women who delivered in our hospital between 2012 and 2016, we retrospectively selected all those who had untreated early fasting hyperglycaemia and separated them into a ‘gestational diabetes’ and a ‘no‐gestational diabetes’ group according to oral glucose tolerance test results after 22 weeks’ gestation. We compared the incidence of a predefined composite outcome (preeclampsia or large‐for‐gestational‐age infant or shoulder dystocia or neonatal hypoglycaemia) in both groups. Results A total of 268 women (mean fasting plasma glucose 5.3 ± 0.3 mmol/l at a mean ± sd of 10.2 ± 4.2 weeks’ gestation) were included. Gestational diabetes developed in 134 women and was independently associated with early fasting plasma glucose ≥ 5.5 mmol/l [odds ratio 3.16 (95% CI 1.57, 6.33)], age ≥ 30 years [odds ratio 2.78 (95% CI 1.46, 5.31)], preconception obesity [odds ratio 2.12 (95% CI 1.11, 4.02)], family history of diabetes [odds ratio 1.87 (95% CI 1.00, 3.50)] and current employment [odds ratio 0.46 (95% CI 0.26, 0.83)]. Despite treatment, gestational diabetes induced a significant increase in the composite outcome as compared to no gestational diabetes (odds ratio 2.16 [95% CI 1.08, 4.34]). The association disappeared after adjustment for risk factors. Conclusions Only half of the women with early fasting hyperglycaemia and no specific care subsequently developed gestational diabetes, and these women had a poor prognosis despite gestational diabetes treatment. Poor prognosis was mostly attributable to risk factors. Our results suggest that only women with certain risk factors should be screened for early fasting hyperglycaemia.

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Section: Prediction Of Incident Gdm In Women With Untreated Efhgsupporting

confidence: 64%

Initially untreated fasting hyperglycaemia in early pregnancy: prognosis according to occurrence of gestational diabetes mellitus after 22 weeks’ gestation: a case–control study

et al. 2019

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“…However, reports in the literature present no consistent guidelines about when GDM screening should begin. Professional organizations recommend that diabetes screening for women with GDM should occur around the time of the first postpartum visit [ 7 – 9 ], whereas the ADA recommends screening at 6–12 weeks after delivery.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Macular Peripapillary Nerve Fiber Layer and Choroidal Thickness Changes in Pregnant Women with Gestational Diabetes Mellitus, Healthy Pregnant Women, and Healthy Non-Pregnant Women

et al. 2015

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BackgroundGestational diabetes mellitus (GDM) is a risk factor for the development of type II diabetes and it causes maternal and child morbidity. Screening for diabetic retinopathy (DR) is important because patients who develop DR have no symptoms until macular edema and/or proliferative diabetic retinopathy (PDR) are already present. The aim of this study was to determine the early retinal findings of GDM.Material/MethodsThis study was conducted in a tertiary research center. We conducted a prospective cross-sectional study with 3 groups: Group 1 consisted of 36 pregnant women with GDM, Group 2 consisted of 24 healthy pregnant women, and Group 3 consisted of 38 healthy non-pregnant women of reproductive age. Spectralis optical coherence tomography (OCT) was used for the assessment. Macular, choroid, and retinal nerve fiber layer (RNFL) thicknesses were evaluated in patients with GDM and comparisons were made among pregnant women with GDM, healthy pregnant women, and healthy non-pregnant women for these parameters.ResultsThe nasal part of the RNFL was significantly thinner in the GDM group than in the healthy pregnant group. None of the patients had retinopathy or macular edema at the time of examination.ConclusionsDecreased nasal part of RNFL thickness may be the first retinal change in patients with GDM. Our study suggests that OCT should be performed for the patients with GDM for detection of early retinal changes associated with GDM.

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“…13 Our results show that, relative to the 1999 WHO criteria, this identified a small additional group of women 20 proposed the use of a blood glucose threshold combination associated with a higher odds ratio of 2.0 (rather than 1.75 as proposed by the IADPSG) for neonatal disorders. This would translate into 75 g OGTT cutoffs of 5.3 mmol/L for the baseline value and 9.0 mmol/L for the 2-hour value for the diagnosis of GDM.…”

Section: Alternative Approachesmentioning

confidence: 84%

Diagnosing gestational diabetes mellitus: implications of recent changes in diagnostic criteria and role of glycated haemoglobin (HbA1c)

et al. 2017

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Gestational diabetes mellitus (GDM; approximately 5% of pregnancies) represents the most important risk factor for development of later-onset diabetes mellitus. We examined concordance between GDM diagnosis defi ned using the original 1999 World Health Organization (WHO) criteria and the more recent 2013 WHO criteria and 2015 National Institute for Health and Care Excellence (NICE) criteria. We studied two groups: a case-control group of 257 GDM positive and 266 GDM negative cases, and an incident cohort 699 GDM positive and 6,231 GDM negative cases. In the incident cohort, GDM prevalence was 3.7% (WHO 1999 criteria), 11.4% (NICE 2015 criteria) and 13.7% (WHO 2013 criteria). Our results showed that a signifi cant number of additional cases are detected using the more recent NICE and WHO criteria than the original 1999 WHO criteria, but these additional cases represent an intermediate group with 'moderate' dysglycaemia (abnormal blood glucose levels). Our results also show that use of these newer criteria misses a similar group of intermediate cases that were defi ned as GDM by the 1999 WHO criteria and that glycated haemoglobin in isolation is unlikely to replace the oral glucose tolerance test in GDM diagnosis.

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

Cited by 11 publications

References 34 publications

Initially untreated fasting hyperglycaemia in early pregnancy: prognosis according to occurrence of gestational diabetes mellitus after 22 weeks’ gestation: a case–control study

Initially untreated fasting hyperglycaemia in early pregnancy: prognosis according to occurrence of gestational diabetes mellitus after 22 weeks’ gestation: a case–control study

Assessment of Macular Peripapillary Nerve Fiber Layer and Choroidal Thickness Changes in Pregnant Women with Gestational Diabetes Mellitus, Healthy Pregnant Women, and Healthy Non-Pregnant Women

Diagnosing gestational diabetes mellitus: implications of recent changes in diagnostic criteria and role of glycated haemoglobin (HbA1c)

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