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]
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To the Editor: We thank Elisabeth Ng and colleagues for their interest in our paper and confirmation of our data . It was interesting to read their experiences with the rising incidence of gestational diabetes mellitus (GDM) in a multi-ethnic, metropolitan maternity hospital in Melbourne (Australia) after implementing the new diagnostic criteria .
Our data have shown that implementing the new WHO 2013 diagnostic thresholds with a higher 2 h plasma glucose (2HG) cut-off value may exclude a group of women who are currently diagnosed with GDM and benefit from treatment (i.e. women with 2HG ≥7.8 but ≤8.4 mmol/l) . Ng et al concur that more evidence is needed to establish whether women with a 2HG level between 7.8 and 8.4 mmol/l can safely be left untreated. They additionally comment that it is necessary to consider the rise in incidence and financial costs that would be likely to accompany an adoption of a lower 2HG threshold . However, it has to be borne in mind that it is...
KeywordsDiagnostic criteria GDM Gestational diabetes Incidence Pregnancy outcomes WHO
2 h plasma glucose
Gestational diabetes mellitus
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 and J. van Amstel (both at 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 article 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.
- 2.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