scholarly journals Modification of WHO diagnostic criteria for gestational diabetes: implications for classification of hyperglycemia in pregnancy

2017 ◽  
Vol 6 (7) ◽  
pp. 2716 ◽  
Author(s):  
Lucius C. Imoh ◽  
Solomon A. Asorose ◽  
Alfred I. Odo ◽  
Daniel O. Aina ◽  
Alexander O. Abu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Tolerance Test ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Oral Glucose ◽  
Exact Test ◽  
Iadpsg Criteria ◽  
In Pregnancy

Background: Low and medium income countries (LMICs) especially in sub-Saharan Africa face unique challenges in screening and diagnosing hyperglycaemia in pregnancy. The implications of applying the 2013 WHO modifications for assessing hyperglycaemia in pregnancy in low resource settings are not known. We evaluated the significance of these recent changes in classification of hyperglycaemia among pregnant Nigerian women.Methods: We reviewed the records of Oral glucose tolerance test conducted on 600 pregnant women at the Jos University Teaching Hospital (JUTH) between July 2012 and June 2016. The collected data were analyzed using Statistical Package for Social Sciences version 18 (SPSS Inc., Chicago, IL, USA). Test for association was done using Fisher’s exact test. P < 0.05 was set as the level of significance.Results: The results show that 15.9%, 20.2% and 15.7% of the women had GDM according to WHO (1999), IADPSG and WHO (2013) diagnostic criteria respectively while 4.8% of the women had DM in pregnancy by WHO 2013 criteria. Overall, 30.2% and 23.9% of women who were classified as GDM by WHO 1999 criteria and IADPSG criteria respectively were qualified to be classified as DM in pregnancy according to the WHO 2013 criteria.Conclusions: The recent Modifications by the WHO 2013 guideline for classifying hyperglycemia in pregnancy may create non-uniform interpretation of OGTT. The confusion in classifying hyperglycemia among pregnant women referred between health centres may become more pronounced. There is an urgent need for a streamlined globally acceptable approach to assessing and classifying hyperglycemia in pregnant women.

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
Keyword(s):  
Diagnostic Criteria ◽  
International Association ◽  
Study Groups ◽  
Tolerance Test ◽  
Geographic Region ◽  
Oral Glucose ◽  
The North ◽  
Iadpsg Criteria ◽  
Before And After ◽  
Diabetes And Pregnancy

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.

scholarly journals Glycemia after Betamethasone in Pregnant Women without Diabetes—Impact of Marginal Values in the 75-g OGTT

Healthcare ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 40
Author(s):  
Ioannis Kakoulidis ◽  
Ioannis Ilias ◽  
Anastasia Linardi ◽  
Aikaterini Michou ◽  
Charalampos Milionis ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Tolerance Test ◽  
Insulin Dosage ◽  
Oral Glucose ◽  
Glycemic Profile ◽  
Normal Glucose ◽  
Marginal Values ◽  
The Mean ◽  
Monitoring Treatment ◽  
In Pregnancy

Betamethasone (BM) administration in pregnancy has been shown to reduce the incidence and severity of neonatal respiratory distress syndrome. Its known diabetogenic impact, combined with placental insulin resistance, leads to a transient increase in glycemia. However, its effect on glucose homeostasis in pregnancy has not been adequately investigated. We closely monitored and assessed the glycemic profile of 83 pregnant women, with normal glucose metabolism, who were given BM during their hospitalization due to threatened premature labor. A significant change in the glycemic profile in most patients was noted, lasting 1.34 ± 1.05 days. Sixty-six of eighty-three women were eventually treated with insulin to maintain glycemia within acceptable limits. The mean ± SD insulin dosage was 12.25 ± 11.28 units/day. The need for insulin therapy was associated with higher BM doses and the presence of marginal values in the 75-g oral glucose tolerance test (OGTT) at 60 min. Our study demonstrates, following BM administration, the need for increased awareness and individualized monitoring/treatment of pregnant women with normal—yet marginal—values in the 75-g OGTT.

scholarly journals Influence of GDM Diagnosis and Treatment on Weight Gain, Dietary Intake and Physical Activity in Pregnant Women with Obesity: Secondary Analysis of the UPBEAT Study

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 359 ◽  
Author(s):  
La’Shay Atakora ◽  
Lucilla Poston ◽  
Louise Hayes ◽  
Angela C. Flynn ◽  
Sara L. White
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Dietary Intake ◽  
Pregnant Women ◽  
Secondary Analysis ◽  
Health Behaviours ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Obese Women ◽  
Iadpsg Criteria

Obesity during pregnancy is associated with the development of gestational diabetes (GDM). This study aimed to assess if the result of an oral glucose tolerance test (OGTT) for GDM influences health (diet and physical activity) behaviours of pregnant women with obesity. In total, 1031 women who participated in the UK Pregnancies Better Eating and Activity Trial (UPBEAT) of a lifestyle intervention from early pregnancy were included. Changes in weight gain, dietary intake and physical activity following an OGTT undertaken between 27+0 and 28+6 weeks’ and 34 and 36 weeks’ gestation were examined using linear regression with appropriate adjustment for confounders. Obese women without GDM (IADPSG criteria) gained 1.9 kg (95% CI −2.2, −1.5, p < 0.001) more weight than women with GDM. Women with GDM demonstrated greater reductions in energy (–142kcal, 95%CI −242.2, −41.9, p = 0.006), carbohydrate intake (−1.5%E 95%CI –2.8, −0.3, p = 0.016) and glycaemic load (–15.2, 95%CI −23.6, –6.7, p < 0.001) and a greater increase in protein intake (2%E, 95%CI 1.3, 2.7, p < 0.001), compared to women without GDM. Trial intervention allocation did not influence any associations observed. The findings emphasise the need for strategies to optimise the health behaviours of pregnant women with obesity, following a negative OGTT for GDM.

scholarly journals Contribution of maternal obesity and weight gain in pregnancy to the occurrence of gestational diabetes

2015 ◽  
Vol 67 (2) ◽  
pp. 583-589
Author(s):  
Cristina Teodorescu ◽  
Carmen Dobjanschi ◽  
Florin Isopescu ◽  
Emilia Rusu ◽  
Antoine Edu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Maternal Obesity ◽  
International Association ◽  
Study Groups ◽  
Tolerance Test ◽  
Oral Glucose

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.

Reproducibility of a 75G oral glucose tolerance test in pregnant women

2015 ◽  
Vol 43 (3) ◽  
Author(s):  
Phylos Bonongwe ◽  
Stephen W. Lindow ◽  
Edward J. Coetzee
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Pregnant Women ◽  
Glucose Tolerance Test ◽  
Fasting Glucose ◽  
Tolerance Test ◽  
University Teaching ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Κ Statistic

AbstractTo determine the reproducibility of the oral glucose tolerance test (OGTT).A retrospective study of 205 women who underwent screening for gestational diabetes.A university teaching hospital in a South African city.Women who had an abnormal OGTT had the test repeated during the same pregnancy without any diabetic or dietary advice given in the intervening time period.Women with two OGTTs in the same pregnancy had a proforma completed at the time. Completed proformas were filed and reviewed for the purpose of this study.The κ statistic was used for estimating the agreement between repeated tests using the same nominal or dichotomous scale.The OGTT was repeated during the index pregnancy in 205 women and in a subset of 76 women within 17 days. The κ statistic was 0.269 for 205 women and 0.212 for 76 women for the fasting glucose value (fair strength of agreement). The κ statistic for the 2-h glucose value was 0.157 for 205 patients and 0.174 for 76 patients (slight strength of agreement). The overall OGGT classification produced κ statistics of 0.167 and 0.150 for the whole group and the 76 patients, respectively.The reproducibility was better with the fasting glucose and less with the 2-h result and the overall OGGT classification. Caution needs to be exercised when interpreting the single positive result of an OGTT in pregnant women.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

scholarly journals The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 666
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Marzieh Saei Ghare Naz ◽  
Razieh Bidhendi Yarandi ◽  
Samira Behboudi-Gandevani
Keyword(s):  
Systematic Review ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Meta Analysis ◽  
Population Based ◽  
Maternal Outcomes ◽  
Care Providers ◽  
Iadpsg Criteria ◽  
The Impact

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

scholarly journals Interpretation of Modified Glucose Tolerance Test among Pregnant Malaysian Women

2020 ◽  
Vol 5 (08) ◽  
pp. 309-313
Author(s):  
Muna Kh. Al-kubaisi ◽  
Saad M. Al-Shibli ◽  
Nilar Win
Keyword(s):  
Glucose Tolerance ◽  
Pregnant Women ◽  
Blood Sample ◽  
Blood Sugar ◽  
Glucose Tolerance Test ◽  
Venous Blood ◽  
Tolerance Test ◽  
Oral Glucose ◽  
The Mean ◽  
Local Protocol

Aim: Is to find the mean and two standard deviation of the serum blood sugar among pregnant women while running the modified oral glucose tolerance test (MOGTT) as screening for gestational diabetes mellitus (GDM) & to compare the readings with other protocols adopted in diagnosing GDM. Method: A cross sectional study among pregnant women running routine MOGTT at 24-28 weeks’ gestation. A total of 149 women participated in 4 months period. The test included 5 ml of venous blood sample taken after fasting for 8 hours and a second blood sample 2 hours after having 200 ml of 75 g glucose solution within 10 minutes. Results: The mean for the fasting blood sugar is 4.32 mmol/L±0.52 making value of 2SD of 5.36 mmol/l. The mean of the 2 hours glucose level was 6.11mmol/l±1.38 making the 2SD value of 8.87 mmol/l. Conclusion: Our results for the 1st reading in MOGTT is near to the value of the local protocol in diagnosing GDM. The 2 hours postprandial reading in the local protocol is fairly low when compared with our findings & with guidelines of nearby communities.

Sign in / Sign up

Export Citation Format

Share Document