Medicalising pregnancy with new diagnostic criteria for gestational diabetes mellitus: do we need more evidence? Reply to Venkataraman H and Saravanan P [letter]
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To the Editor: We thank doctors Venkataraman and Saravanan for their letter and supportive comments .
The authors express their concerns about the reported differences in crude birthweight and not sex- and gestational-age-adjusted birthweight z scores. In our paper we reported a significantly lower birthweight in the WHO 1999 2HG only group compared with the normal glucose tolerance (NGT) group upon testing . This is to be expected, as women classified with gestational diabetes mellitus (GDM) according the WHO 1999 criteria were treated with diet and/or insulin therapy. Venkataraman and Saravanan comment that it is likely that these differences were insignificant if birthweight z scores adjusted for gestational age and sex were used.
To make a correction for birthweight in relation to gestational age/time of delivery and sex, we reported the lowest and highest birth percentiles in our paper (small for gestational age: birthweight <10th percentile and large for gestational age...
KeywordsDiagnostic criteria GDM Gestational diabetes Incidence Pregnancy outcomes WHO
2 h plasma glucose
gestational diabetes mellitus
large for gestational age
normal glucose tolerance
The authors wish to thank the endocrinologists, gynaecologists, diabetes specialist nurses, and dieticians of the University Medical Center and Martini Hospital Groningen. Special thanks are expressed to the participating midwife practices: De Verloskundigenpraktijk van Groningen, Verloskundigenpraktijk Hoogezand, Verloskundigenpraktijk La Vie, Verloskundigenpraktijk New Life, Verloskundige Stadspraktijk, Verloskundigenpraktijk ‘t Stroomdal, Verloskundigenpraktijk Veendam. We would also like to thank H. Hepkema-Geerligs (customer relations manager Laboratory of Clinical Chemistry, Certe, the Netherlands) and the students S. Klöppner (University Medical Center Groningen, the Netherlands) and J. van Amstel (University Medical Center Groningen, the Netherlands) for their contribution to the data collection. Finally, we thank epidemiologist H. Groen (department of Epidemiology, University Medical Center Groningen, the Netherlands), the Dutch Perinatal Registry and the Municipal Health Service Groningen for providing the data on the reference population in the northern region of the Netherlands.
All authors were responsible for drafting the letter and revising it critically for important intellectual content. All authors approved the version to be published.
Novo Nordisk Netherlands provided an unrestricted research grant. The study sponsor was not involved in the designs of the study; the collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication.
Duality of interest
The authors declare that there is no duality of interest associated with this manuscript.
- 1.Venkataraman H, Saravanan P (2018) Medicalising pregnancy with new diagnostic criteria for gestational diabetes mellitus: do we need more evidence? Diabetologia https://doi.org/10.1007/s00125-018-4666-3
- 6.Ng E, Neff M, Sztal-Mazer S (2018) Insights uncovered from experiencing a rise in the incidence of gestational diabetes at a Melbourne hospital. Diabetologia. https://doi.org/10.1007/s00125-018-4631-1
- 7.Koning SH, van Zanden JJ, Hoogenberg K et al (2018) Insights uncovered from experiencing a rise in the incidence of gestational diabetes at a Melbourne hospital. Reply to Ng E, Neff M, Sztal-Mazer S [letter]. Diabetologia https://doi.org/10.1007/s00125-018-4667-2