The Toronto Tri-Hospital Gestational Diabetes Project

Sermer, Mathew; Naylor, C. David; Farine, Dan; Kenshole, Anne B.; Ritchie, J. W. K.; Gare, Douglas J.; Cohen, Howard; McArthur, Karen; Holzapfel, Stephen; Biringer, Anne

doi:10.1097/00006254-199903000-00005

Cited by 62 publications

(88 citation statements)

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“…Other studies [20][21][22] with limited power have examined the association between the ADA thresholds [6,9] with perinatal complications among white women who did not meet the NDDG criteria [5]. Magee et al [20] reported that among 34 women who met only the ADA criteria [9] the average percentage incidence of the composite measure of 33 possible perinatal complications was 41% higher than in women with normal screening.…”

Section: Discussionmentioning

confidence: 99%

“…Magee et al [20] reported that among 34 women who met only the ADA criteria [9] the average percentage incidence of the composite measure of 33 possible perinatal complications was 41% higher than in women with normal screening. The Toronto Tri-Hospital Gestational Diabetes project [21] found that the proportion of infants with birthweight >4,500 g was higher among 115 women who met only the ADA thresholds [9] than in 2,940 women with normal screening (6.1 vs 1.9%). Recently, Ricart et al [22] reported that after controlling for possible confounders, the risk of macrosomia (defined as birthweight >4,000 g) was somewhat higher in 263 women who met only the ADA criteria [9] than in 6,350 women with normal screening (OR=1.45, 95% CI=0.83-2.52).…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia

et al. 2006

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Aims/hypothesis Gestational diabetes mellitus (GDM) is a risk factor for perinatal complications. In several countries, the criteria for the diagnosis of GDM have been in flux, the American Diabetes Association (ADA) thresholds recommended in 2000 being lower than those of the National Diabetes Data Group (NDDG) that have been in use since 1979. We sought to determine the extent to which infants of women meeting only the ADA criteria for GDM are at increased risk of neonatal complications. Materials and methods In a multiethnic cohort of 45,245 women who did not meet the NDDG criteria and were not treated for GDM, we conducted nested case-control studies of three complications of GDM that occurred in their infants: macrosomia (birthweight >4,500 g, n=494); hypoglycaemia (plasma glucose <2.2 mmo/l, n=488); and hyperbilirubinaemia (serum bilirubin ≥342 μmol/l (20 mg/dl), n=578). We compared prenatal glucose levels of the mothers of these infants and mothers of 884 control infants. Results Women with GDM by ADA criteria only (two or more glucose values exceeding the threshold) had an increased risk of having an infant with macrosomia (odds ratio OR = 3.40, 95% CI = 1.55-7.43), hypoglycaemia (OR=2.61, 95% CI=0.99-6.92) or hyperbilirubinaemia (OR=2.22, 95% CI=0.98-5.04). Glucose levels 1 h after the 100-g glucose challenge that exceeded the ADA threshold were particularly strongly associated with each complication. Conclusions/interpretation These results lend support to the ADA recommendations and highlight the importance of the 1-h glucose measurement in a diagnostic test for GDM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia

et al. 2006

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“…Macrosomia is an important factor in high cesarean delivery rates for women with untreated borderline GDM. 1 Several studies suggested that maternal circulating fatty acids play important roles in fetal growth and development. 7,8 Elevated Fatty acids in the maternal circulation are associated with increased insulin resistance and β-cell dysfunction, which play a role in the development of gestational diabetes mellitus (GDM) and increases the risk of adverse perinatal outcomes, including preterm delivery.…”

Section: Discussionmentioning

confidence: 99%

“…1 Untreated GDM is associated with a higher incidence of complications during pregnancy and increased perinatal mortality and morbidity.…”

Section: Introductionmentioning

confidence: 99%

Does mild hyperglycemia in 75gm Glucose Tolerance Test (GTT) affect outcome in pregnant women?

Prabhu¹,

Muthulakshmi²

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Glucose tolerance in pregnancy is fundamentally linked to fetal growth. The relationship between maternal glycemia and adverse outcomes is a continuous process, with no distinct cut off point for increased risk. The objective of the study is to find out whether mild hyperglycemia in 2 hour 75 gm Glucose Tolerance Test (GTT) affects maternal and perinatal outcome in pregnant women.Methods: This case control study was conducted in SRM Medical College during a 10-month period. Mild hyperglycemia was diagnosed when the - 2hour non- fasting 75gm GTT was between 120-139 mg/dl and Controls were women with 2hour nonfasting 75gm GTT <120mg/dl. Maternal and neonatal parameters were noted and the results were compared.Results: During the study period 142 delivered women had mild hyperglycemia, of which 10 patients on subsequent blood sugar monitoring required insulin for blood sugar control. There was significant family history of diabetes in women with mild hyperglycemia when compared to controls. There was no significant difference in incidence of hypertension, hypothyroidism, preterm delivery and caesarean section between the two groups. LGA (Large for gestational age babies) (p=0.001) and serum triglyceride levels (p=0.04) were significantly more in women with mild hyperglycemia when compared to controls.Conclusions: Mild hyperglycemia during pregnancy should not be ignored and periodic blood sugar monitoring should be done to improve maternal and fetal outcome.

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“…Intenzivan monitoring je vodio do toga da su pacijentkinje uzimale veće doze insulina (do 90 u/d) i imale niži procenat carskog reza i makrozomije (31). Suprotno navedenoj studiji, u Toronto Tri-Hospital Gestational Diabetes Project (THGDP) studiji nađeno je sniženje stepena makrozomije, ali ne i stepena carskog reza kod 145 intenzivirano lečenih žena (32). Tokom intenzivnog tretmana insulinom nađen je veći procenat hipoglikemije kod majke (17%) kao i niža incidencija neonatalne žutice i neonatalne hipoglikemije.…”

Section: Tabela 2 Dijagnostički Kriterijumi Za Gdmunclassified

Gestational diabetes mellitus

Mladenović¹,

Dukic²,

Mirjana³

et al. 2016

Medicinski casopis

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Gestacijski diabetes mellitus (GDM) definiše se kao bilo koji stepen glukozne intolerancije, s početkom ili prvim pojavljivanjem tokom trudnoće (1, 2). Ova definicija ne uključuje samo žene kod kojih se dijabetes pojavljuje kao prolazni poremećaj tokom trudnoće i nestaje posle porođaja, već i one kod kojih se pojavljuje tip 1 dijabetesa (T1DM), kao novootkriveni u trudnoći, i traje i posle porođaja. Definicija se primenjuje bez obzira na to da li se koristi insulin ili samo dijeta u lečenju i ukoliko stanje perzistira i posle trudnoće. To ne isključuje mogućnost da se neprepoznata intolerancija glukoze ispoljila s trudnoćom (2, 3). GDM je obično blag i ne ugrožava život trudnice, ali hiperglikemija povećava fetalni morbiditet. Prema heterogenosti poremećaja koji se definiše kao hiperglikemija, Svetska zdravstvena organizacija je 1985. godine svrstala GDM u poseban tip dijabetesa (4, 5). GESTACIJSKI DIABETES MELLITUS

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The Toronto Tri-Hospital Gestational Diabetes Project

Cited by 62 publications

References 0 publications

Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia

Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia

Does mild hyperglycemia in 75gm Glucose Tolerance Test (GTT) affect outcome in pregnant women?

Gestational diabetes mellitus

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