TY - JOUR

T1 - Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk

AU - Scheuer, Cathrine Munk

AU - Jensen, Dorte Møller

AU - McIntyre, H. David

AU - Ringholm, Lene

AU - Mathiesen, Elisabeth Reinhardt

AU - Nielsen, Celina Pforr Korsgård

AU - Nolsöe, Rúna Louise Mortansdóttir

AU - Milbak, Julie

AU - Hillig, Thore

AU - Damm, Peter

AU - Overgaard, Martin

AU - Clausen, Tine Dalsgaard

N1 - Funding Information: Open access funding provided by Royal Library, Copenhagen University Library. This work was supported by a research grant from the Danish Diabetes Academy, which is funded by the Novo Nordisk Foundation, grant number NNF17SA0031406, by Jascha Fonden, Nordsjællands Hospital, the Research Fund of the Capital Region of Denmark, Steno Diabetes Center Odense, The Research Fund of the Danish Medical Association, Frimodt-Heineke Fonden, and Tvergaards Fond. Publisher Copyright: © 2023, The Author(s).

PY - 2023

Y1 - 2023

N2 - Aims: To estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds. Methods: Diagnostic testing was performed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks’ gestation in a cohort of pregnant women. GDM diagnosis was based on the current Danish criterion (2-h glucose ≥ 9.0 mmol/L, GDMDK) and on the WHO2013 criteria (fasting ≥ 5.1, 1 h ≥ 10.0 or 2 h glucose ≥ 8.5 mmol/L, GDMWHO2013). Currently untreated women fulfilling the WHO2013 but not the Danish diagnostic criteria were defined as New-GDM-women (GDMWHO2013-positive and GDMDK-negative). Adverse outcomes risks were calculated using logistic regression. Results: OGTT was completed by 465 women at a median of 25.7 weeks’ gestation. GDMDK prevalence was 2.2% (N = 10) and GDMWHO2013 21.5% (N = 100). New-GDM was present in 19.4% (N = 90), of whom 90.0% had elevated fasting glucose. Pregnancies complicated by New-GDM had higher frequencies of pregnancy-induced hypertension (13.3% vs 4.1%, p = 0.002), large-for-gestational-age infants (22.2% vs 9.9%, p = 0.004), neonatal hypoglycaemia (8.9% vs 1.9%, p = 0.004) and neonatal intensive care unit admission (16.7% vs 5.8%, p = 0.002) compared to pregnancies without GDM. Conclusions: GDM prevalence increased tenfold when applying WHO2013 criteria in a Danish population, mainly driven by higher fasting glucose levels. Untreated GDM in the gap between the current Danish and the WHO2013 diagnostic criteria resulted in higher risks of adverse pregnancy outcomes.

AB - Aims: To estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds. Methods: Diagnostic testing was performed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks’ gestation in a cohort of pregnant women. GDM diagnosis was based on the current Danish criterion (2-h glucose ≥ 9.0 mmol/L, GDMDK) and on the WHO2013 criteria (fasting ≥ 5.1, 1 h ≥ 10.0 or 2 h glucose ≥ 8.5 mmol/L, GDMWHO2013). Currently untreated women fulfilling the WHO2013 but not the Danish diagnostic criteria were defined as New-GDM-women (GDMWHO2013-positive and GDMDK-negative). Adverse outcomes risks were calculated using logistic regression. Results: OGTT was completed by 465 women at a median of 25.7 weeks’ gestation. GDMDK prevalence was 2.2% (N = 10) and GDMWHO2013 21.5% (N = 100). New-GDM was present in 19.4% (N = 90), of whom 90.0% had elevated fasting glucose. Pregnancies complicated by New-GDM had higher frequencies of pregnancy-induced hypertension (13.3% vs 4.1%, p = 0.002), large-for-gestational-age infants (22.2% vs 9.9%, p = 0.004), neonatal hypoglycaemia (8.9% vs 1.9%, p = 0.004) and neonatal intensive care unit admission (16.7% vs 5.8%, p = 0.002) compared to pregnancies without GDM. Conclusions: GDM prevalence increased tenfold when applying WHO2013 criteria in a Danish population, mainly driven by higher fasting glucose levels. Untreated GDM in the gap between the current Danish and the WHO2013 diagnostic criteria resulted in higher risks of adverse pregnancy outcomes.

KW - Diagnosis

KW - Gestational diabetes mellitus

KW - IADPSG

KW - Outcomes

KW - Prevalence

KW - WHO

U2 - 10.1007/s00592-023-02148-2

DO - 10.1007/s00592-023-02148-2

M3 - Journal article

C2 - 37462764

AN - SCOPUS:85165105409

VL - 60

SP - 1663

EP - 1673

JO - Acta Diabetologica

JF - Acta Diabetologica

SN - 0940-5429

IS - 12

ER -