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Comparing the diagnostic criteria for gestational diabetes mellitus of World Health Organization 2013 with 1999 in Chinese population.

Zhu W, Yang H, Wei Y, Wang Z, Li X, Wu H, Li N, Zhang M, Liu X, Zhang H, Wang Y, Niu J, Gan Y, Zhong L, Wang Y, Kapur A - Chin. Med. J. (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

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Gestational diabetes mellitus (GDM) was earlier defined as “hyperglycemia first recognized during pregnancy” and has more recently been described by American Diabetes Association (ADA) (2012) as diabetes diagnosed during pregnancy that is not clearly overt diabetes... After reviewing the results of the HAPO study, many international diabetes study groups, including the International Association of Diabetes and Pregnancy Study Groups and ADA have adopted the 75 g oral glucose tolerance test (OGTT) at 24−28 weeks as a screening and diagnostic test and defined new cut-off values for GDM diagnosis... Two different cut-off values of plasma glucose were used to analyze the data: GDM was diagnosed by WHO 2013 criteria when one of the following plasma glucose value was met or exceeded: 0 hour, 5.10 mmol/L; 1 hour, 10.00 mmol/L; 2 hours, 8.50 mmol/L; GDM was diagnosed by WHO 1999 criteria when 0 hour ≥7.00 mmol/L or 2 hours ≥7.80 mmol/L... An additional 5.8% of pregnant women were diagnosed GDM by 2013 criteria only and 5.5% only by 1999 criteria... Similar results are seen from other countries-in the United Arab Emirates 20.3% to 37.7%; Australia 9.6% to 13.0%... Compared to these other studies where the difference were substantial (3.4–17.4%), the prevalence did not change (0.3%) with the two criteria in China... However, the result shows that GDM patients identified by the two criteria are not exactly same (5.8% were identified only by the WHO 2013 criteria and 5.5% only by the WHO 1999 criteria)... When the old WHO criteria changes to the new criteria, from the point of view of reducing complications, the 5.5% pregnant women will not been treated and the outcome in these untreated women needs to be considered... Furthermore, GDM patients diagnosed only by WHO 1999 criteria displayed higher mean 2 hours postprandial plasma glucose value (8.09 mmol/L) than the ones diagnosed only by WHO 2013 criteria (6.63 mmol/L). de Veciana et al. reported that adjustment of insulin therapy in women with GDM according to the results of postprandial has a better outcome than preprandial... We will use the survey data to compare the outcome of different group... The diagnostic criteria of WHO (2013) and WHO (1999) show disparity and do not exactly identify the same population of pregnant women with GDM in China... For most hospitals in Hongkong and in Yunnan province that use the WHO 1999 criteria, this must be kept in mind when changing to the 2013 criteria for GDM.

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The distribution of gestational diabetes mellitus patients with different criteria in China.
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Figure 1: The distribution of gestational diabetes mellitus patients with different criteria in China.

Mentions: As shown in Figure 1 and Table 1, GDM prevalence was similar using both the WHO 1999 and 2013 criteria (17.2% and 17.5%, respectively). The constituent ratio of normal and GDM patients diagnosed by both criteria were 77.0% and 11.6% respectively. The consistency rate of the two criteria was 88.6%. An additional 5.8% of pregnant women were diagnosed GDM by 2013 criteria only and 5.5% only by 1999 criteria.


Comparing the diagnostic criteria for gestational diabetes mellitus of World Health Organization 2013 with 1999 in Chinese population.

Zhu W, Yang H, Wei Y, Wang Z, Li X, Wu H, Li N, Zhang M, Liu X, Zhang H, Wang Y, Niu J, Gan Y, Zhong L, Wang Y, Kapur A - Chin. Med. J. (2015)

The distribution of gestational diabetes mellitus patients with different criteria in China.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837807&req=5

Figure 1: The distribution of gestational diabetes mellitus patients with different criteria in China.
Mentions: As shown in Figure 1 and Table 1, GDM prevalence was similar using both the WHO 1999 and 2013 criteria (17.2% and 17.5%, respectively). The constituent ratio of normal and GDM patients diagnosed by both criteria were 77.0% and 11.6% respectively. The consistency rate of the two criteria was 88.6%. An additional 5.8% of pregnant women were diagnosed GDM by 2013 criteria only and 5.5% only by 1999 criteria.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Gestational diabetes mellitus (GDM) was earlier defined as “hyperglycemia first recognized during pregnancy” and has more recently been described by American Diabetes Association (ADA) (2012) as diabetes diagnosed during pregnancy that is not clearly overt diabetes... After reviewing the results of the HAPO study, many international diabetes study groups, including the International Association of Diabetes and Pregnancy Study Groups and ADA have adopted the 75 g oral glucose tolerance test (OGTT) at 24−28 weeks as a screening and diagnostic test and defined new cut-off values for GDM diagnosis... Two different cut-off values of plasma glucose were used to analyze the data: GDM was diagnosed by WHO 2013 criteria when one of the following plasma glucose value was met or exceeded: 0 hour, 5.10 mmol/L; 1 hour, 10.00 mmol/L; 2 hours, 8.50 mmol/L; GDM was diagnosed by WHO 1999 criteria when 0 hour ≥7.00 mmol/L or 2 hours ≥7.80 mmol/L... An additional 5.8% of pregnant women were diagnosed GDM by 2013 criteria only and 5.5% only by 1999 criteria... Similar results are seen from other countries-in the United Arab Emirates 20.3% to 37.7%; Australia 9.6% to 13.0%... Compared to these other studies where the difference were substantial (3.4–17.4%), the prevalence did not change (0.3%) with the two criteria in China... However, the result shows that GDM patients identified by the two criteria are not exactly same (5.8% were identified only by the WHO 2013 criteria and 5.5% only by the WHO 1999 criteria)... When the old WHO criteria changes to the new criteria, from the point of view of reducing complications, the 5.5% pregnant women will not been treated and the outcome in these untreated women needs to be considered... Furthermore, GDM patients diagnosed only by WHO 1999 criteria displayed higher mean 2 hours postprandial plasma glucose value (8.09 mmol/L) than the ones diagnosed only by WHO 2013 criteria (6.63 mmol/L). de Veciana et al. reported that adjustment of insulin therapy in women with GDM according to the results of postprandial has a better outcome than preprandial... We will use the survey data to compare the outcome of different group... The diagnostic criteria of WHO (2013) and WHO (1999) show disparity and do not exactly identify the same population of pregnant women with GDM in China... For most hospitals in Hongkong and in Yunnan province that use the WHO 1999 criteria, this must be kept in mind when changing to the 2013 criteria for GDM.

Show MeSH
Related in: MedlinePlus