What does the adoption of new international guidelines mean for screening and diagnosis of gestational diabetes mellitus?


Authors: Kateřina Anderlová 1,2;  Hana Krejčí 1,2;  Martin Haluzík 1
Authors‘ workplace: III. interní klinika 1. LF UK a VFN Praha 1;  Gynekologicko-porodnická klinika 1. LF UK a VFN Praha 2
Published in: Forum Diab 2014; 3(2): 67-73
Category: Review

Overview

Gestational diabetes mellitus (GDM) is a disorder of glucose metabolism occurring in pregnancy which spontaneously disappears after delivery. However, it often occurs in other pregnancy or latter during life as diabetes mellitus type 2. The incidence of gestational diabetes increases worldwide similarly as incidence of diabetes mellitus type 2. Although, older data in Czech sources have shown prevalence of GDM in 3–4% pregnancies, currently, the prevalence is twofold higher using the same diagnostic criteria. Screening and diagnostic criteria are not internationally unified. In 2010, the International Association of Diabetes and Pregnancy Study Group – IADPSG published new guidelines for diagnosis of GDM based on results of international multicenter trial HAPO (Hyperglycemia and Adverse Pregnancy Outcomes). HAPO study is the first study which has observed the effect of mild hyperglycemia on development of gestational and perinatal complications in big cohort of pregnant women. IADPSG criteria have been adopted by many countries and by WHO as well. In April 2014, the IADPSG criteria were adopted by Czech Diabetes Society of the Czech Medical Association of Jan Evangelista Purkyne. Currently, ongoing discussion is under way among profesional societies of gynecologists and biochemists for establishment of unified algorithm in GDM diagnosis. In the article we show our data from retrospective analysis of oral glucose tolerance test which was performed on pregnant women in Czech Republic. The results reveal that the adoption of new guidelines for GDM will further increase the incidence of GDM (due to lower threshold for fasting glucose) which will demand changes in management of pregnant women with GDM.

Key words:
GDM – gestational diabetes – oGTT – oral glucose tolerant test – study Hyperglycemia and adverse pregnancy outcomes (HAPO)


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Labels
Diabetology Endocrinology Internal medicine
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