scholarly journals Trends in National Canadian Guideline Recommendations for the Screening and Diagnosis of Gestational Diabetes Mellitus over the Years: A Scoping Review

2021 ◽  
Vol 18 (4) ◽  
pp. 1454
Author(s):  
Joseph Mussa ◽  
Sara Meltzer ◽  
Rachel Bond ◽  
Natasha Garfield ◽  
Kaberi Dasgupta
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Scoping Review ◽  
Adverse Pregnancy Outcome ◽  
National Guidelines ◽  
Screening Programs ◽  
Canadian Guideline ◽  
Diagnostic Threshold ◽  
Adverse Pregnancy

Canada’s largest national obstetric and diabetology organizations have recommended various algorithms for the screening of gestational diabetes mellitus (GDM) over the years. Though uniformity across recommendations from clinical practice guidelines (CPGs) is desirable, historically, national guidelines from Diabetes Canada (DC) and the Society of Obstetricians and Gynaecologists of Canada (SOGC) have differed. Lack of consensus has led to variation in screening approaches, rendering precise ascertainment of GDM prevalence challenging. To highlight the reason and level of disparity in Canada, we conducted a scoping review of CPGs released by DC and the SOGC over the last thirty years and distributed a survey on screening practices among Canadian physicians. Earlier CPGs were based on expert opinion, leading to different recommendations from these organizations. However, as a result of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, disparities between DC and the SOGC no longer exist and many Canadian physicians have adopted their recent recommendations. Given that Canadian guidelines now recommend two different screening programs (one step vs. two step), lack of consensus on a single diagnostic threshold continues to exist, resulting in differing estimates of GDM prevalence. Our scoping review highlights these disparities and provides a step forward towards reaching a consensus on one unified threshold.

Exercise and Its Effects on Gestational Diabetes Mellitus and Related Parameters

2020 ◽  
Author(s):  
Sheema Yousuf
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
International Association ◽  
Adverse Pregnancy Outcome ◽  
Controlled Study ◽  
P Value ◽  
Oral Glucose ◽  
Adverse Pregnancy

Background: Gestational Diabetes Mellitus (GDM) has now become one of the most common and important complication of pregnancy worldwide. There are conflicting results of various studies regarding the role of exercise in reducing the risk of GDM. Therefore, the aim of this study was to determine the effectiveness of exercise on prevention of gestational diabetes. Methods: It is a randomized controlled study directed in the obstetrics and gynecology outpatient clinic of Pakistan Institute of Medical Sciences (PIMS) hospital Islamabad beginning from 6 June 2016 to 5 December 2016 including 170 pregnant women satisfying the inclusion criteria. Group A received routine antenatal care while Group B included the pregnant women that were advised brisk walk for 30 minutes three days per week. At 24-28 week of pregnancy, 75gm oral glucose tolerance test (OGTT) was performed and International association for Diabetes in Pregnancy Study Group (IADPSG) and Hyperglycemia and adverse pregnancy outcome (HAPO) standards, determined GDM. Chi Square was applied for comparing GDM frequency and p value ≤0.05 was considered as significant. Results: The mean age of the patients was 28.08 ± 4.15 years and mean gestation of pregnancy was 17.18 ± 0.78 weeks. Gestational diabetes was seen in 08 (9.41%) patients of non-exercising group while in exercise group only 01 (1.18%) patient had GDM (p-value 0.016). Conclusion: Moderate exercise during pregnancy decreases the risk of gestational diabetes mellitus and is safe for the mother and the baby. However, more studies are needed to establish recommendations.

scholarly journals ISFHAC as a novel predictor of macrosomia in gestational diabetes mellitus and normal pregnancy

2020 ◽  
Author(s):  
Zhi-Guo Chen ◽  
Ya-Ting Xu ◽  
Lu-Lu Ji ◽  
Xiao-Li Zhang ◽  
Xiao-Xing Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Adverse Pregnancy Outcome ◽  
Area Under The Curve ◽  
Normal Pregnancy ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Validation Data ◽  
Adverse Pregnancy

Abstract Background Macrosomia is a major adverse pregnancy outcome of gestational diabetes mellitus (GDM). Although BMI, symphysis-fundal height (SFH) and abdominal circumference (AC) are associated with fetal weight, there are some limitations to their use, especially for the prediction of macrosomia. This study aimed to identify a novel predictive methodology to improve the prediction of high-risk macrosomia. Methods Clinical information was collected from 3730 patients. The association between the ISFHAC (the index of SFH algorithm multiplied by the square of AC) and fetal weight was performed and validated. A new index, the ISFHAC, was evaluated by area under the curve (AUC) analysis. Results A total of 1087 GDM and 657 normal singleton pregnancies were analyzed. ISFHAC was positively correlated with fetal weight in GDM pregnancies and normal pregnancies (NPs). The AUCs of the ISFHAC were 0.815 in the GDM group and 0.804 in the NP group. The ISFHAC cutoff points were 41.7 and 37 in the GDM and NP groups, respectively. The sensitivity values for the prediction of macrosomia with high ISFHAC were 75.9% and 81.3% in the GDM and NP groups, respectively, which were higher than that for the prediction of BMI. Regarding the validation data, the sensitivity values for prediction with a high ISFHAC were 78.9% (559 GDM pregnancies) and 78.3% (1427 NPs). Conclusions The ISFHAC can be regarded as a new predictor and risk factor for macrosomia in GDM pregnancy and NP.

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