scholarly journals Implementation of the International Association of Diabetes and Pregnancy Study Groups Criteria: Not Always a Cause for Concern

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Pooja Sibartie ◽  
Julie Quinlivan

Background. Controversy surrounds the decision to adopt the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) as fears that disease prevalence rates will soar have been raised.Aims. To investigate the prevalence of pregnancy complicated with GDM before and after the introduction of the IADPSG 2010 diagnostic criteria.Materials and Methods. A prospective audit of all women who delivered from July 1, 2010, to June 30, 2014, in a predefined geographic region within the North Metropolitan Health Service of Western Australia. Women were diagnosed with GDM according to Australian Diabetes in Pregnancy Society (ADIPS 1991) criteria until December 31, 2011, and by the IADPSG 2010 criteria after this date. Incidence of GDM and predefined pregnancy outcomes were audited.Results. Of 10,296 women, antenatal oral glucose tolerance test (OGTT) results and follow-up data were obtained for 10,103 women (98%), of whom 349 (3.5%) were diagnosed with GDM. The rate of GDM utilising ADIPS criteria was 3.4% and the rate of utilising IADPSG criteria was 3.5% (p=0.92).Conclusion. IADPSG diagnostic criteria did not significantly increase the incidence of GDM in this low prevalence region.

2012 ◽  
Vol 5 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mariya V Boyadzhieva ◽  
Iliana Atanasova ◽  
Sabina Zacharieva ◽  
Tsvetalina Tankova ◽  
Violeta Dimitrova

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.


2015 ◽  
Vol 67 (2) ◽  
pp. 583-589
Author(s):  
Cristina Teodorescu ◽  
Carmen Dobjanschi ◽  
Florin Isopescu ◽  
Emilia Rusu ◽  
Antoine Edu ◽  
...  

An increase in prevalence of gestational diabetes mellitus (GDM) was observed using new diagnostic criteria. We evaluated the prevalence of GDM in a population of pregnant women (109 women with gestational age of 24-28 weeks) and risk factors for GDM, such as maternal obesity and weight gain. The evaluation of each patient included an oral glucose tolerance test (OGTT) using the new diagnostic criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) for GDM, 2D ultrasounds and the registration of risk factors. The prevalence of GDM in the age group ?30 years was 11.9%, which is comparable to the results of other studies. The relative risk (RR) for GDM was 1.738 (95% CI 0.630-4.795) in women over 30 years and 3.782 (95% CI 1.127-12.686) in women over 35. Weight gain in the group with GDM was significantly higher than in the group that included pregnant women without GDM (p <0.01). Considering the high risk of GDM with excessive gestational weight gain, educational nutrition programs should be established for the fertile-age population, not only to prevent obesity but also to prevent excessive weight gain during pregnancy.


2013 ◽  
Vol 6 (3) ◽  
pp. 125-128 ◽  
Author(s):  
Tarakeswari Surapaneni ◽  
Irfana Nikhat ◽  
Praveen K Nirmalan

Background To determine the diagnostic effectiveness of the fasting and one-hour plasma glucose levels for gestational diabetes (GDM) based on International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Methods A Cross-sectional study that included 2348 pregnant women booked for antenatal care in 2011 at a tertiary care perinatal institute. Pregnant women underwent a 75 g oral glucose tolerance test (OGTT) between 24 and 28 weeks of gestation. Outcome measures include the incidence of GDM based on the IADPSG criteria and the diagnostic effectiveness of the recommended fasting and one-hour plasma glucose cut-off if used in isolation. Results The incidence of GDM was 21.81% ( n = 520, 95% CI: 20.15, 23.57) with the IADPSG criteria. A fasting plasma glucose cut-off 92 mg/dL, in isolation, correctly classified 87.16% of GDM, with a specificity of 96.08%, clinically significant positive likelihood ratio (14.08) and a post-test probability of 79.71%. The one-hour 75 g test, in isolation, correctly classified 85.74% of GDM, had specificity of 99.68% and clinically significant positive likelihood ratio (111.12) and post-test probability of 96.87%. The application of the World Health Organization criteria would misclassify 11.91% (95% CI: 10.66, 13.26) of GDM as normal. Conclusions Additional testing of plasma glucose levels can be avoided for 18.25% ( n = 435, 95% CI: 16.73, 19.84) if the IADPSG diagnostic criteria for GDM are applied with exit on a positive fasting or one-hour test result.


Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 806
Author(s):  
Przemysław Ustianowski ◽  
Damian Malinowski ◽  
Patrycja Kopytko ◽  
Michał Czerewaty ◽  
Maciej Tarnowski ◽  
...  

Gestational diabetes mellitus (GDM) is carbohydrate intolerance that occurs during pregnancy. This disease may lead to various maternal and neonatal complications; therefore, early diagnosis is very important. Because of the similarity in pathogenesis of type 2 diabetes and GDM, the genetic variants associated with type 2 diabetes are commonly investigated in GDM. The aim of the present study was to examine the associations between the polymorphisms in the ADCY5 (rs11708067, rs2877716), CAPN10 (rs2975760, rs3792267), and JAZF1 (rs864745) genes and GDM as well as to determine the expression of these genes in the placenta. This study included 272 pregnant women with GDM and 348 pregnant women with normal glucose tolerance. The diagnosis of GDM was based on a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks gestation, according to International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. There were no statistically significant differences in the distribution of the ADCY5 gene (rs11708067, rs2877716) and CAPN10 gene (rs2975760, rs3792267) polymorphisms between pregnant women with normal carbohydrate tolerance and pregnant women with GDM. We have shown a lower frequency of JAZF1 gene rs864745 C allele carriers among women with GDM CC + CT vs. TT (OR = 0.60, 95% CI = 0.41–0.87, p = 0.006), and C vs. T (OR = 0.75, 95% CI = 0.60–0.95, p = 0.014). In addition, ADCY5 and JAZF1 gene expression was statistically significantly increased in the placentas of women with GDM compared with that of healthy women. The expression of the CAPN10 gene did not differ significantly between women with and without GDM. Our results indicate increased expression of JAZF1 and ADCY5 genes in the placentas of women with GDM as well as a protective effect of the C allele of the JAZF1 rs864745 gene polymorphism on the development of GDM in pregnant women.


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