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Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk
AIMS: To estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds. METHODS: Diagnostic...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Milan
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587026/ https://www.ncbi.nlm.nih.gov/pubmed/37462764 http://dx.doi.org/10.1007/s00592-023-02148-2 |
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author | Scheuer, Cathrine Munk Jensen, Dorte Møller McIntyre, H. David Ringholm, Lene Mathiesen, Elisabeth Reinhardt Nielsen, Celina Pforr Korsgård Nolsöe, Rúna Louise Mortansdóttir Milbak, Julie Hillig, Thore Damm, Peter Overgaard, Martin Clausen, Tine Dalsgaard |
author_facet | Scheuer, Cathrine Munk Jensen, Dorte Møller McIntyre, H. David Ringholm, Lene Mathiesen, Elisabeth Reinhardt Nielsen, Celina Pforr Korsgård Nolsöe, Rúna Louise Mortansdóttir Milbak, Julie Hillig, Thore Damm, Peter Overgaard, Martin Clausen, Tine Dalsgaard |
author_sort | Scheuer, Cathrine Munk |
collection | PubMed |
description | AIMS: To estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds. METHODS: Diagnostic testing was performed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks’ gestation in a cohort of pregnant women. GDM diagnosis was based on the current Danish criterion (2-h glucose ≥ 9.0 mmol/L, GDM(DK)) and on the WHO2013 criteria (fasting ≥ 5.1, 1 h ≥ 10.0 or 2 h glucose ≥ 8.5 mmol/L, GDM(WHO2013)). Currently untreated women fulfilling the WHO2013 but not the Danish diagnostic criteria were defined as New-GDM-women (GDM(WHO2013)-positive and GDM(DK)-negative). Adverse outcomes risks were calculated using logistic regression. RESULTS: OGTT was completed by 465 women at a median of 25.7 weeks’ gestation. GDM(DK) prevalence was 2.2% (N = 10) and GDM(WHO2013) 21.5% (N = 100). New-GDM was present in 19.4% (N = 90), of whom 90.0% had elevated fasting glucose. Pregnancies complicated by New-GDM had higher frequencies of pregnancy-induced hypertension (13.3% vs 4.1%, p = 0.002), large-for-gestational-age infants (22.2% vs 9.9%, p = 0.004), neonatal hypoglycaemia (8.9% vs 1.9%, p = 0.004) and neonatal intensive care unit admission (16.7% vs 5.8%, p = 0.002) compared to pregnancies without GDM. CONCLUSIONS: GDM prevalence increased tenfold when applying WHO2013 criteria in a Danish population, mainly driven by higher fasting glucose levels. Untreated GDM in the gap between the current Danish and the WHO2013 diagnostic criteria resulted in higher risks of adverse pregnancy outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00592-023-02148-2. |
format | Online Article Text |
id | pubmed-10587026 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
spelling | pubmed-105870262023-10-21 Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk Scheuer, Cathrine Munk Jensen, Dorte Møller McIntyre, H. David Ringholm, Lene Mathiesen, Elisabeth Reinhardt Nielsen, Celina Pforr Korsgård Nolsöe, Rúna Louise Mortansdóttir Milbak, Julie Hillig, Thore Damm, Peter Overgaard, Martin Clausen, Tine Dalsgaard Acta Diabetol Original Article AIMS: To estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds. METHODS: Diagnostic testing was performed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks’ gestation in a cohort of pregnant women. GDM diagnosis was based on the current Danish criterion (2-h glucose ≥ 9.0 mmol/L, GDM(DK)) and on the WHO2013 criteria (fasting ≥ 5.1, 1 h ≥ 10.0 or 2 h glucose ≥ 8.5 mmol/L, GDM(WHO2013)). Currently untreated women fulfilling the WHO2013 but not the Danish diagnostic criteria were defined as New-GDM-women (GDM(WHO2013)-positive and GDM(DK)-negative). Adverse outcomes risks were calculated using logistic regression. RESULTS: OGTT was completed by 465 women at a median of 25.7 weeks’ gestation. GDM(DK) prevalence was 2.2% (N = 10) and GDM(WHO2013) 21.5% (N = 100). New-GDM was present in 19.4% (N = 90), of whom 90.0% had elevated fasting glucose. Pregnancies complicated by New-GDM had higher frequencies of pregnancy-induced hypertension (13.3% vs 4.1%, p = 0.002), large-for-gestational-age infants (22.2% vs 9.9%, p = 0.004), neonatal hypoglycaemia (8.9% vs 1.9%, p = 0.004) and neonatal intensive care unit admission (16.7% vs 5.8%, p = 0.002) compared to pregnancies without GDM. CONCLUSIONS: GDM prevalence increased tenfold when applying WHO2013 criteria in a Danish population, mainly driven by higher fasting glucose levels. Untreated GDM in the gap between the current Danish and the WHO2013 diagnostic criteria resulted in higher risks of adverse pregnancy outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00592-023-02148-2. Springer Milan 2023-07-18 2023 /pmc/articles/PMC10587026/ /pubmed/37462764 http://dx.doi.org/10.1007/s00592-023-02148-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Scheuer, Cathrine Munk Jensen, Dorte Møller McIntyre, H. David Ringholm, Lene Mathiesen, Elisabeth Reinhardt Nielsen, Celina Pforr Korsgård Nolsöe, Rúna Louise Mortansdóttir Milbak, Julie Hillig, Thore Damm, Peter Overgaard, Martin Clausen, Tine Dalsgaard Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk |
title | Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk |
title_full | Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk |
title_fullStr | Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk |
title_full_unstemmed | Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk |
title_short | Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk |
title_sort | applying who2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587026/ https://www.ncbi.nlm.nih.gov/pubmed/37462764 http://dx.doi.org/10.1007/s00592-023-02148-2 |
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