Prevalence of Gestational Diabetes Mellitus by Three Groups of Criteria – a Critical View
Issue: 1/2011
Author: Petya Karatodorova, Kiril Hristozov, Boyana Zvetanova, Yana Bocheva, Nataliya Usheva
Abstract:
In March 2010 the new IADPSG – recommendations on the diagnosis and classifications of hyperglycemia in pregnancy were published. Their acceptance and usage in the daily practice will probably lead to substantial change in the epidemiological picture of GDM formed until now mainly by ADA- and WHO-criteria.
Aim: to compare the impact of three groups of criteria (ADA, WHO, IADPSG) on GDM prevalence.
Patients and methods: we tested 299 pregnant women (mean age 28,9±4,4, mean gestational age 27,4±3,5); all participants filled in a standardized questionnaire, underwent an anthropometry (height, weight) and a 75g-OGTT. The GDM prevalence was determined by ADA-, WHO- and IADPSG-criteria.
Results: GDM prevalence is as follows: by WHO – 16,7% (n=50); by ADA – 9,7% (n=29); by IADPSG – 34,4% (n=103). After the additional applying of ADA- and WHO-criteria in the group with GDM by IADPSG, the distribution of the participants is: 53,4% – with normal glucose tolerance by ADA and WHO; 20,4% – with GDM by ADA and WHO; 18,4% – with GDM by WHO; 7,8% – GDM by ADA.
Conclusion: In comparison with ADA- and WHO-criteria, the applying of the new IADPSG recommendations increases substantially GDM prevalence. Fasting plasma glucose measurement is sufficient for detection of GDM in about 60% of the cases. The high risk profile of the studied group is a potential explanation for the high prevalence of GDM by the three diagnostic groups.
