W216 THE INFLUENCE OF MATERNAL PRE-PREGNANCY BMI ON PRENATAL RISKS AND TREATMENT EFFECTS FOR PATIENTS NEWLY DIAGNOSED WITH GESTATIONAL DIABETES MELLITUS (GDM) BASED ON THE REVISION OF THE DIAGNOSTIC CRITERIA

2012 ◽  
Vol 119 ◽  
pp. S775-S775 ◽  
Author(s):  
T. Ogura ◽  
H. Hamada ◽  
H. Yoshikawa
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
Treatment Effects ◽  
Newly Diagnosed

scholarly journals Are newly introduced criteria for the diagnosis of gestational diabetes mellitus associated with improved pregnancy outcomes and/or increased interventions in New South Wales, Australia? A population-based data linkage study

2021 ◽  
Vol 9 (1) ◽  
pp. e002277
Author(s):  
Deborah A Randall ◽  
Jonathan M Morris ◽  
Patrick Kelly ◽  
Sarah J Glastras
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
New South ◽  
New South Wales ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Newly Diagnosed ◽  
South Wales

IntroductionThe incidence of gestational diabetes mellitus (GDM) is increasing in Australia, influenced by changed diagnostic criteria. We aimed to identify whether the diagnostic change was associated with improved outcomes and/or increased obstetric interventions using state-wide data in New South Wales (NSW), Australia.Research design and methodsPerinatal and hospital data were linked for singleton births, 33–41 weeks’ gestation, 2006–2015, NSW. An adjusted Poisson model was used to split pregnancies from 2011 onwards into those that would have been diagnosed under the old criteria (‘previous GDM’) and newly diagnosed cases (‘additional GDM’). We compared actual rates of total and early (<39 weeks) planned births, cesareans, and maternal and neonatal adverse outcomes for GDM-diagnosed pregnancies using three predicted scenarios, where the ‘additional GDM’ group was assumed to have the same rates as: the ‘previous GDM’ group <2011 (scenario A); the ‘non-GDM’ group <2011 (scenario B); or the ‘non-GDM’ group ≥2011 (scenario C).ResultsGDM incidence more than doubled over the study period, with an inflection point observed at 2011. For those diagnosed with GDM since 2011, the actual incidence of interventions (planned births and cesareans) and macrosomia was consistent with scenario A, which meant higher intervention rates, but lower rates of macrosomia, than those with no GDM. Incidence of neonatal hypoglycemia was lower than scenario A and closer to the other scenarios. There was a reduction in perinatal deaths among those with GDM, lower than that predicted by all scenarios, indicating an improvement for all with GDM, not only women newly diagnosed. Incidence of maternal and neonatal morbidity indicators was within the confidence bounds for all three predicted scenarios.ConclusionsOur study suggests that the widely adopted new diagnostic criteria for GDM are associated with increased obstetric intervention rates and lower rates of macrosomic babies, but with no clear impacts on maternal or neonatal morbidity.

scholarly journals Medicalising pregnancy with new diagnostic criteria for gestational diabetes mellitus: do we need more evidence? Reply to Venkataraman H and Saravanan P [letter]

Diabetologia ◽  
2018 ◽  
Vol 61 (8) ◽  
pp. 1889-1891
Author(s):  
Sarah H. Koning ◽  
Jelmer J. van Zanden ◽  
Klaas Hoogenberg ◽  
Helen L. Lutgers ◽  
Alberdina W. Klomp ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria

The impact of potential new diagnostic criteria on the prevalence of gestational diabetes mellitus in Australia

2011 ◽  
Vol 194 (7) ◽  
pp. 338-340 ◽  
Author(s):  
Robert G Moses ◽  
Gary J Morris ◽  
Peter Petocz ◽  
Fernando San Gil ◽  
Dinesh Garg
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
The Impact

scholarly journals Estimated Treatment Effects of Tight Glycaemic Targets in Mild Gestational Diabetes Mellitus: A Multiple Cut-Off Regression Discontinuity Study Design

2020 ◽  
Vol 17 (21) ◽  
pp. 7725
Author(s):  
David Song ◽  
James C Hurley ◽  
Maryanne Lia
Keyword(s):  
Diabetes Mellitus ◽  
Relative Risk ◽  
Caesarean Section ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Treatment Effects ◽  
Regression Discontinuity ◽  
Neonatal Hypoglycaemia ◽  
Diagnostic Thresholds ◽  
High Insulin

Background: We investigated the treatment effects of tight glycaemic targets in a population universally screened according to the International Association of Diabetes and Pregnant Study Groups (IADPSG)/World Health Organisation (WHO) gestational diabetes mellitus (GDM) guidelines. As yet there, have been no randomized control trials evaluating the effectiveness of treatment of mild GDM diagnosed under the IADPSG/WHO diagnostic thresholds. We hypothesize that tight glycaemic control in pregnant women diagnosed with GDM will result in similar clinical outcomes to women just below the diagnostic thresholds. Methods: A multiple cut-off regression discontinuity study design in a retrospective observational cohort undergoing oral glucose tolerance tests (OGTT) (n = 1178). Treatment targets for women with GDM were: fasting capillary blood glucose (CBG) of ≤5.0 mmol/L and the 2-h post-prandial CBG of ≤6.7 mmol/L. Regression discontinuity study designs estimate treatment effects by comparing outcomes between a treated group to a counterfactual group just below the diagnostic thresholds with the assumption that covariates are similar. The counterfactual group was selected based on a composite score based on OGTT plasma glucose categories. Results: Women treated for GDM had lower rates of newborns large for gestational age (LGA), 4.6% versus those just below diagnostic thresholds 12.6%, relative risk 0.37 (95% CI, 0.16–0.85); and reduced caesarean section rates, 32.2% versus 43.0%, relative risk 0.75 (95% CI, 0.56–1.01). This was at the expense of increases in induced deliveries, 61.8% versus 39.3%, relative risk 1.57 (95% CI, 1.18–1.9); notations of neonatal hypoglycaemia, 15.8% versus 5.9%, relative risk 2.66 (95% CI, 1.23–5.73); and high insulin usage 61.1%. The subgroup analysis suggested that treatment of women with GDM with BMI ≥30 kg/m2 drove the reduction in caesarean section rates: 32.9% versus 55.9%, relative risk 0.59 (95%CI, 0.4–0.87). Linear regression interaction term effects between non-GDM and treated GDM were significant for LGA newborns (p = 0.001) and caesarean sections (p = 0.015). Conclusions: Tight glycaemic targets reduced rates of LGA newborns and caesarean sections compared to a counterfactual group just below the diagnostic thresholds albeit at the expense of increased rates of neonatal hypoglycaemia, induced deliveries, and high insulin usage.

scholarly journals Effect of the new diagnostic criteria for gestational diabetes mellitus among Japanese women

2014 ◽  
Vol 6 (3) ◽  
pp. 226-231 ◽  
Author(s):  
Etsuko Nobumoto ◽  
Hisashi Masuyama ◽  
Yuji Hiramatsu ◽  
Takashi Sugiyama ◽  
Hideto Kusaka ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
Japanese Women

Studies on Diagnostic Criteria for Gestational Diabetes Mellitus by 75 g Glucose Tolerance Test

2010 ◽  
Vol 13 (2) ◽  
pp. 187-193 ◽  
Author(s):  
Teiji Hamada ◽  
Masahiro Tetsuou ◽  
Kiyotaka Yoshimatsu ◽  
Noriaki Amagase ◽  
Toshiyuki Ooshima ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
Glucose Tolerance Test ◽  
Tolerance Test

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

2017 ◽  
Vol 17 (2) ◽  
pp. 108-113 ◽  
Author(s):  
Fahmy W Hanna ◽  
Christopher J Duff ◽  
Ann Shelley-Hitchen ◽  
Ellen Hodgson ◽  
Anthony A Fryer
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
Glycated Haemoglobin

scholarly journals Comparative analysis of current diagnostic criteria for gestational diabetes mellitus

2012 ◽  
Vol 5 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mariya V Boyadzhieva ◽  
Iliana Atanasova ◽  
Sabina Zacharieva ◽  
Tsvetalina Tankova ◽  
Violeta Dimitrova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
International Association ◽  
Study Groups ◽  
World Health ◽  
Oral Glucose ◽  
Significant Difference ◽  
Iadpsg Criteria

Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% ( P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.

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