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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)

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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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Mean plasma glucose values (mmol/L) of the four groups.
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Figure 2: Mean plasma glucose values (mmol/L) of the four groups.

Mentions: As shown in Table 1 and Figure 2, the mean of plasma glucose values at 0 hour, 1 hour and 2 hours show statistically significant differences between any two groups (P < 0.001). Women meeting GDM diagnostic criteria of both 1999 and 2013, had the highest mean plasma glucose value at 1 h (10.16 ± 1.63 mmol/L) and 2 h (9.31 ± 1.22 mmol/L), whereas women meeting the 2013 criteria only displayed the highest mean value at 0 hour (5.19 ± 0.47 mmol/L) and lower mean value at 2 hours (6.63 ± 0.88 mmol/L) compared to women meeting the 1999 criteria, who had higher mean 2 hours (8.09 ± 0.19 mmol/L) value.


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)

Mean plasma glucose values (mmol/L) of the four groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Mean plasma glucose values (mmol/L) of the four groups.
Mentions: As shown in Table 1 and Figure 2, the mean of plasma glucose values at 0 hour, 1 hour and 2 hours show statistically significant differences between any two groups (P < 0.001). Women meeting GDM diagnostic criteria of both 1999 and 2013, had the highest mean plasma glucose value at 1 h (10.16 ± 1.63 mmol/L) and 2 h (9.31 ± 1.22 mmol/L), whereas women meeting the 2013 criteria only displayed the highest mean value at 0 hour (5.19 ± 0.47 mmol/L) and lower mean value at 2 hours (6.63 ± 0.88 mmol/L) compared to women meeting the 1999 criteria, who had higher mean 2 hours (8.09 ± 0.19 mmol/L) value.

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