Screening for Gestational Diabetes

Pillay, Jennifer; Donovan, Lois; Guitard, Samantha; Zakher, Bernadette; Gates, Michelle; Gates, Allison; Vandermeer, Ben; Bougatsos, Christina; Chou, Roger; Hartling, Lisa

doi:10.1001/jama.2021.10404

Cited by 60 publications

(70 citation statements)

References 109 publications

(269 reference statements)

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“…To update the 2014 recommendation, 33 the USPSTF commissioned a systematic review to evaluate the accuracy, benefits, and harms of screening for gestational diabetes and the benefits and harms of treatment for the pregnant person and infant. 29,34 Preges-tational diabetes (undiagnosed type 2 diabetes) is not in the scope of this recommendation.…”

Section: Scope Of Reviewmentioning

confidence: 99%

Screening for Gestational Diabetes

Force¹,

Davidson

Barry

et al. 2021

JAMA

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ImportanceGestational diabetes is diabetes that develops during pregnancy. [1][2][3] Prevalence of gestational diabetes in the US has been estimated at 5.8% to 9.2%, based on traditional diagnostic criteria, although it may be higher if more inclusive criteria are used. [4][5][6][7][8] Pregnant persons with gestational diabetes are at increased risk for maternal and fetal complications, including preeclampsia, fetal macrosomia (which can cause shoulder dystocia and birth injury), and neonatal hypoglycemia. 3,[9][10][11] Gestational diabetes has also been associated with an increased risk of several long-term health outcomes in pregnant persons and intermediate outcomes in their offspring. [12][13][14][15][16] IMPORTANCE Gestational diabetes is diabetes that develops during pregnancy. Prevalence of gestational diabetes in the US has been estimated at 5.8% to 9.2%, based on traditional diagnostic criteria, although it may be higher if more inclusive criteria are used. Pregnant persons with gestational diabetes are at increased risk for maternal and fetal complications, including preeclampsia, fetal macrosomia (which can cause shoulder dystocia and birth injury), and neonatal hypoglycemia. Gestational diabetes has also been associated with an increased risk of several long-term health outcomes in pregnant persons and intermediate outcomes in their offspring.OBJECTIVE The USPSTF commissioned a systematic review to evaluate the accuracy, benefits, and harms of screening for gestational diabetes and the benefits and harms of treatment for the pregnant person and infant.POPULATION Pregnant persons who have not been previously diagnosed with type 1 or type 2 diabetes. EVIDENCE ASSESSMENTThe USPSTF concludes with moderate certainty that there is a moderate net benefit to screening for gestational diabetes at 24 weeks of gestation or after to improve maternal and fetal outcomes. The USPSTF concludes that the evidence on screening for gestational diabetes before 24 weeks of gestation is insufficient, and the balance of benefits and harms of screening cannot be determined.RECOMMENDATION The USPSTF recommends screening for gestational diabetes in asymptomatic pregnant persons at 24 weeks of gestation or after. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes in asymptomatic pregnant persons before 24 weeks of gestation. (I statement)

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Section: Scope Of Reviewmentioning

confidence: 99%

Screening for Gestational Diabetes

Force¹,

Davidson

Barry

et al. 2021

JAMA

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“…However, these alternatives have limitations, and none is validated for Tajikistan or any other central Asian country 22 23 . Interestingly, a recent report by the US Preventive Services Task Force indicates that many aspects of screening for gestational diabetes, remain unclear also in developed countries 24 .…”

Section: Discussionmentioning

confidence: 99%

Screening for Gestational Diabetes Mellitus and Pregnancy Outcomes: Results from a Multicentric Study in Tajikistan

Pirmatova

Додхоева

Hasbargen

et al. 2022

Exp Clin Endocrinol Diabetes

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The prevalence of gestational diabetes parallels the prevalence of type 2 diabetes mellitus and is associated with adverse pregnancy outcomes. However, these data are not available for many parts of the world. We assessed the prevalence of gestational diabetes and pregnancy outcomes in Tajikistan. This cohort study included 2438 consecutively recruited representative pregnant women from 8 locations in two cities in Tajikistan, in whom an oral glucose tolerance test (75 g, fasting, 1 h, 2 h) was performed during gestational weeks 24–28. Women with known diabetes and twin pregnancies were excluded. Associations between glucose tolerance test results and pregnancy outcomes were examined. According to the WHO 2013 thresholds, 32.4% of women qualified as having gestational diabetes, the vast majority (29.7%) based on an elevated fasting glucose level (5.1–5.6 mmol/L), while only 2.8% had elevated 1- or 2-hour values or met more than one threshold. Women with only elevated fasting glucose (impaired gestational fasting glycemia) had no evidence of adverse pregnancy outcomes, while those with elevated 1- and/or 2-hour values (impaired gestational glucose tolerance) had more pregnancy complications (infection of urinary tract 1.8 vs. 8.8% p<0.001; preeclampsia 0.7 vs. 10.3% p<0.001) and emergency cesarean sections (4.4 vs. 13.2% p=0.002). Neonates from pregnancies with impaired gestational glucose tolerance had lower APGARs, lower birth weights, lower 30 min glucose levels, and a lower probability of being discharged alive (all p<0.05). In conclusion, the formal prevalence of gestational diabetes is high in Tajikistan; however, this does not translate into adverse pregnancy outcomes for women with impaired gestational fasting glycemia.

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“…Zur Effektivität der Therapie hat ein aktueller Evidenzbericht auf der Basis von 8 randomisierten und 1 nicht randomisierten Studie mit insgesamt 3982 Schwangeren 16 statistisch signifikante Verbesserungen von relevanten Endpunkten belegen können ( Tab. 1 ).…”

Section: Differentialdiagnose: Monogener Diabetesunclassified

Diabetes mellitus und Schwangerschaft

Kleinwechter¹,

Nolte²,

Demandt³

2023

Dtsch Med Wochenschr

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Therapiebedürftige Hyperglykämien gehören weltweit zu den häufigsten Schwangerschaftskomplikationen. Die größte Gruppe bilden Frauen mit Gestationsdiabetes mellitus, gefolgt von Frauen mit bekanntem Typ-1- und Typ-2-Diabetes mellitus. Die Betreuung ist komplex und verlangt ein gutes Zusammenspiel verschiedener Fachgebiete. Dieser Beitrag bietet eine Übersicht zu bewährten Therapie-Strategien und erläutert neue Erkenntnisse, u. a. zur SARS-CoV-2-Pandemie.

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Screening for Gestational Diabetes

Cited by 60 publications

References 109 publications

Screening for Gestational Diabetes

Screening for Gestational Diabetes

Screening for Gestational Diabetes Mellitus and Pregnancy Outcomes: Results from a Multicentric Study in Tajikistan

Diabetes mellitus und Schwangerschaft

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