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Abstract
Following the hyperglycaemia and Adverse Pregnancy Outcome study the International Association of Diabetes in Pregnancy Study Group (IADPSG) has suggested new criteria for the diagnosis of gestational diabetes mellitus (GDM). The IADPSG criteria diagnoses GDM if one or more values equals or exceeds thresholds of fasting plasma glucose (FPG) of 5.1 mmol/l and/or a 2 h plasma glucose level of 8.5 mmol/l following a 75 g oral glucose tolerance test (OGTT). One study has shown that a FPG of 4.4 mmol/l could be the first screening step for the condition.
Aims (1) To compare the IADPSG criteria with the World Health Organization (WHO) criteria for diagnosis of GDM. (2). To determine the sensitivity and specificity of a FPG value of 4.4 mmol/l in predicting GDM in high risk population.
Method We reviewed results of 2-h OGTT performed in 5503 high risk antenatal women booked at New Cross Hospital, Wolverhampton.
Results The IADPSG and WHO criteria identified GDM in 932(16.9%) and 759(13.9%) women respectively. The table 1 shows the efficacy of a FPG value of 4.4 mmol/l for screening for GDM:
The efficacy of a FPG value of 4.4m.mol/l in screening for GDM
Comment The IADPSG criteria increases the number of patients classified with GDM by 3%. Screening by FPG of 4.4 mmol/l will reduce the need for OGTTs by 45% in our population and could make a considerable saving in cost. These results confirm the findings of research from the United Arab Emirates.