gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Influence of new criteria for the diagnosis of gestationaldiabetes mellitus on its expected frequency of occurrenceand complications


Abstract

Author(s): LUIZA OLESZCZUK-MODZELEWSKA, KRZYSZTOF CZAJKOWSKI

Gestational diabetes mellitus (GDM) is the most common glucose tolerance disorder diagnosedduring pregnancy. It is associated with complications for the mother, fetus and the child in thefuture. A prospective multicenter study, called HAPO, demonstrated a linear relationship betwe-en glycemia in OGTT in pregnant patients and macrosomia, the frequency of cesarean sections,the level of c-peptide in the umbilical blood and neonatal hypoglycemia. Based on its results,the International Association of Diabetes and Pregnancy Study Group (IADPSG) and the WorldHealth Organization (WHO) have proposed new criteria for GDM diagnosis. The Polish Gyne-cologic Society (Polskie Towarzystwo Ginekologiczne, PTG) accepted them in 2014.According to the previous criteria, a fasting glucose level ranged from 95 to 126 mg/dl andincreased to 140 mg/dl after 2 hours (ADA criteria from 2004, WHO from 1999 and PTG from2011) [1–3]. Due to lower fasting glucose limit values in a OGTT test (to 92 mg/dl) andincreased level after 2 hours (up to 153 mg/dl), a question arises concerning the influence ofthese new criteria on the frequency of GDM and complications during pregnancy and in thefetus (4–6).A considerable number of studies conducted so far indicate an increase in diagnoses of ge-stational diabetes mellitus compared with the previous criteria. It is also suggested that thenumber of labor inductions and cesarean sections has also increased. It is estimated that thetreatment of mild hyperglycemia would reduce the percentage of macrosomia, shoulder dys-tocia and the need for hospitalization of newborns at neonatal intensive care units [7]. It isstill postulated that the new criteria should be verified in large, prospective randomized trials.

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