Medicalising pregnancy with new diagnostic criteria for gestational diabetes mellitus: do we need more evidence?
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To the Editor: We read with interest the article by Koning et al . The authors report that the additional women diagnosed with gestational diabetes mellitus (GDM) by the WHO 2013 definition (i.e. fasting plasma glucose [FPG] ≥5.1 mmol/l but ≤6.9 mmol/l) were more likely to be obese and have higher BMI and hypertension compared with women with normal glucose tolerance (NGT).
They also report, based on unadjusted analysis using χ2test and Fisher’s exact tests, that the additional group of women diagnosed by the WHO 2013 FPG criteria (WHO 2013 only fasting glucose: GDM according to new WHO 2013 fasting glucose threshold, but do not meet WHO 1999 criteria) had higher rates of planned Caesarean section and induced labour despite similar unadjusted birthweight, macrosomia and large for gestational age (LGA) rates to the NGT group. The ‘WHO 1999 only 2HG’ group (GDM according to WHO 1999 2HG threshold, but do not meet WHO 2013 criteria), who received treatment for GDM had similar rates...
KeywordsDiagnostic criteria Gestational diabetes Neonatal outcome Obesity Pregnancy
2 h plasma glucose
Fasting plasma glucose
Gestational diabetes mellitus
Hyperglycemia and Adverse Pregnancy Outcome (study)
Large for gestational age
Normal glucose tolerance
All authors were responsible for drafting the article and revising it critically for important intellectual content. All authors approved the version to be published.
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Duality of interest
The authors declare that there is no duality of interest associated with this manuscript.
- 9.Duran A, Sáenz S, Torrejón MJ et al (2014) Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St. Carlos Gestational Diabetes Study. Diabetes Care 37:2442–2450CrossRefPubMedGoogle Scholar