Redefinition of gestational diabetes mellitus
Sažetak
Background: An ongoing epidemic of obesity and type 2 diabetes mellitus worldwide, as well as a more advanced maternal age has increased the number of women with undiagnosed gestational diabetes mellitus (GDM). International Association of Diabetes and Pregnancy Study Groups (IADPSG) has recently issued recommendations on the diagnosis and classification of hyperglicemia in pregnancy, and American Diabetes Association (ADA) adopted them and revised the previous criteria. Therefore, the aim of the study was to evaluate the prevalence of GDM according to IADPSG/ADA recommendations and to compare them with the current World Health Organization (WHO) and the old ADA criteria.
Methods: The study included 208 women between the ages of 16 and 42 years who underwent a two-hour oral glucose tolerance test (OGTT) with 75 g glucose between 24 and 28 weeks of gestation, without previously diagnosed overt diabetes.
Results: Based on IADPSG/ADA criteria, GDM was diagnosed in 44 women (21.1%) who were significantly older than their healthy counterparts (33.2±5.42 years vs. 29.4±5.12 years; p=0.0001). Only 12 women (27.3%) with GDM were younger than 30 years, whereas a total of 32 women (72.7%) were older than 30 years. On the other hand, using WHO criteria, GDM was diagnosed in 10.1 % women, and only 2.4% women were diagnosed with GDM based on the old ADA criteria.
Conclusion: The use of new diagnostic glucose values increases the prevalence of GDM, as compared with current WHO and former ADA criteria. Preventive measures should be aimed by Public Health Initiatives for reducing this trend.
Reference
American Diabetes Association. Standards of medical care in diabetes 2011. Diabetes Care. 2011; 34 (Suppl 1): S11-S61.
Lawrence JM, Contreras R, Chen W, and Sacks DA. Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnicically diverse population of pregnant women, 1999-2005. Diabetes Care 2008; 31: 899-904.
Solomon C, Willet WC, Carey VJ, Rich-Edwards J, Hunter DJ, Colditz GA, et al. A prospective Study of Pregravid Determinants of Gestational Diabetes Mellitus. JAMA 1997; 278 (13): 1078-1083.
Vrachnis N, Belitsos P, Sifakis S, Dafopoulos K, Siristatidis C, Pappa KI, et al. Role of Adipokines and Other Inflammatory Mediators in Gestational Diabetes Mellitus and Previous Gestational Diabetes Mellitus. Int J Endocrinol 2012; 549748.
Catalano PM, Kirwan JP, Haugel-de Mouzon S, and King J. Gestational Diabetes and Insulin Resistance: Role in Short- and Long-Term Implications for Mother and Fetus. J Nutr 2003; 133: 1674S–1683S.
Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004; 350: 2362-2374.
Tirosh A, Shai I, Afek A, Dubnov-Raz G, Ayalon N, Gordon B, et al. Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med 2011; 364: 1315-1325.
The HAPO Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcomes. N Engl J Med 2008; 358: 1991-2002.
International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 33: 676-682.
Tietz NW, ed. Clinical Guide to Laboratory Tests, 4 th edition. Philadelphia: WB Saunders 2006; 444-451.
Vučić Lovrenčić M, Honović L, Kralik S, Matica J, Prešek M, Pape-Medvidović E, et al. Redefinition of gestational diabetes mellitus: implications for laboratory practice in Croatia. Biochem Med 2013; 23(1):7-11.
American Diabetes Association: Gestational diabetes mellitus. Diabetes Care 2003; 26 (Suppl. 1): S103-S105.
WHO Consultation: Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications: Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. WHO/NCD/NCS/99.2. World Health Organization, Geneva, 1999.
Waugh N, Pearson D, Royle P. Screening for hyperglicaemia in pregnancy: consensus and controversy. Best Pract Res Clin Endocrinol Metab 2010; 24: 553-571.
Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 2009; 361: 1339-1348.
Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS, et al. Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005; 352: 2477-2486.
Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, and Mc Duffie RS. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program. Diabetes Care 2005; 28: 579-584.
- Autori zadržavaju autorska prava i pružaju časopisu pravo prvog objavljivanja rada i licenciraju ga Creative Commons Attribution licencom koja omogućava drugima da dele rad, uz uslov navođenja autorstva i izvornog objavljivanja u ovom časopisu.
- Autori mogu izraditi zasebne, ugovorne aranžmane za neekskluzivnu distribuciju rada objavljenog u časopisu (npr. postavljanje u institucionalni repozitorijum ili objavljivanje u knjizi), uz navođenje da je rad izvorno objavljen u ovom časopisu.
- Autorima je dozvoljeno i podstiču se da postave objavljeni rad onlajn (npr. u institucionalni repozitorijum ili na svoju internet stranicu) pre ili tokom postupka prijave rukopisa, s obzirom da takav postupak može voditi produktivnoj razmeni ideja i ranijoj i većoj citiranosti objavljenog rada (Vidi Efekte otvorenog pristupa).