New Criteria Identify More Women with Gestational Diabetes

International guidelines put more women in the threshold for having gestational diabetes (GD), as well as at an increased risk of developing prediabetes and type 2 diabetes. 

The research, published in JAMA, used criteria from the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Of 4,697 mothers (mean age, 41.7 years), 14.3% met the criteria for GD. Carpenter-Coustan criteria, used in the United States, only estimates that about 7% of women have GD. And according to the Centers for Disease Control and Prevention, the disease affects between 2% and 10% of pregnancies in any given year. 

Compared with those without it, GD was significantly associated with a higher maternal risk for a disorder of glucose metabolism during long-term follow-up after pregnancy. https://t.co/8RJzrnQgCY @TrueHealthDiag

— Thomas Dayspring (@Drlipid) September 12, 2018

After a mean follow-up of 11.4 years, 52.2% of the mothers with GD developed a glucose metabolism disorder, compared to 20.1% of the mothers who did not have GD (odds ratio [OR], 3.44). 

The study also included 4,832 children to determine if mothers with GD were more likely to have children who were obese or overweight. Researchers found an insignificant trend indicating that mothers with GD were at a slightly increased risk of having overweight/obese children (OR, 1.21). 

Women w/ gestational #diabetes have a 48% increased risk to develop diabetes & hyperglycemia after #pregnancyhttps://t.co/79KlCIxoRQ pic.twitter.com/83ZSu5aies

— Eva M,MD (@ElmTreeMedical) September 11, 2018

“This study demonstrated that a larger population of women with lesser degrees of hyperglycemia (i.e., IADPSG-defined gestational diabetes) were at risk for progression to prediabetes and type 2 diabetes,” wrote the study authors. “Gestational diabetes according to the Carpenter-Coustan criteria as defined in this study was linked to higher outcome risks. However, the risks for the large group of women meeting the IADPSG-defined criteria for gestational diabetes were substantial and cannot be ignored from a public health perspective.” 

Dr. Caroline Messer, a spokesperson for the American Association of Clinical Endocrinologists who was not involved in the study, told MedPageToday that perhaps it makes sense to use the IADPSG guidelines as they appear more effective. 

“In addition, we should be screening mothers who had a history of gestational diabetes for pre-diabetes and diabetes at regular intervals in the future,” she said. 

Sources: JAMA, MedPageToday