Gestational diabetes: differences between the current international diagnostic criteria and implications of switching to IADPSG

• Published in: Journal of diabetes and its complications 2015-05, Vol.29 (4), p.544-549
• Main Authors: Agarwal, M.M, Dhatt, G.S, Othman, Y
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Algorithms; Blood Glucose - analysis; Criteria; Diabetes; Diabetes, Gestational - blood; Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Diabetes, Gestational - ethnology; Diagnosis; Endocrinology; Endocrinology & Metabolism; Female; Gestational diabetes; Glucose; Glucose Tolerance Test - standards; Humans; IADPSG; Internationality; Laboratories; Mass Screening - methods; Maternal Age; Middle Aged; Plasma; Pregnancy; Prenatal Diagnosis - methods; Prevalence; United Arab Emirates - epidemiology; Womens health; Young Adult
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2015.03.006

Abstract Aims To highlight the differences between eight international expert panel diagnostic criteria (either current or outdated but in use) for the diagnosis of gestational diabetes mellitus (GDM) and implications of switching to the International Association of Diabetes in Pregnancy Study Groups (IADPSG) criterion. Methods 2337 pregnant women underwent a 75-g oral glucose tolerance test as part of a universal screening protocol. The GDM prevalence and number of women classified differently were compared between the criteria of the American Diabetes Association (2003); Australasian Diabetes in Pregnancy Society (1998); the Canadian Diabetes Association, CDA (2003 & 2013); the European Association for the Study of Diabetes (1996); IADPSG (2010); the New Zealand Society for the Study of Diabetes (2004) and the World Health Organization (1999). Results The prevalence varied from 9.2% to 45.3% with the different criteria. The IADPSG compared a) best with CDA 2013 [356(15.2%) women classified differently, (kappa, k = 68.3%)] and b) worst with CDA 2003 [843 (36.1%) women classified differently, (k = 21.8%)]; p < 0.001.Switching to IADPSG from the original criteria would increase the prevalence 1.5–4.9 times. Conclusions In 2015, the various international guidelines for GDM continue to show major discrepancies in the prevalence and the women classified dissimilarly. A consensus on a single global guideline would be a giant leap forward.