Adoption of New Screening Guidelines Ups GDM Diagnosis
(HealthDay News) – Implementation of the International Association of Diabetes in Pregnancy Study Group (IADPSG) recommendations for gestational diabetes mellitus (GDM) screening in Israel would increase GDM diagnoses by approximately 50%, with risk stratification recommended to reduce over-treatment.
Ofra Kalter-Leibovici, MD, of the Gertner Institute for Epidemiology and Health Policy Research in Tel-Hashomer, Israel, and colleagues analyzed data from 3,345 women participating in the Israeli Hyperglycemia and Adverse Pregnancy Outcomes study to evaluate the regional implications of implementing the IADPSG recommendations for GDM. Adverse outcome rates were calculated and compared for women who were positive according to IADPSG criteria; IADPSG criteria with risk stratification; or screening with fasting plasma glucose (FPG) and body mass index (BMI).
The researchers found that implementation of the new recommendations in Israel would lead to an increase in the diagnosis of GDM cases by approximately 50%. However, one-third of these women could be managed less intensively because of their low risk for adverse outcomes. Similar proportions of adverse outcomes to those seen with IADPSG criteria could be detected with a FPG level ≥89mg/dL or a BMI of ≥33.5kg/m² at 28–32 weeks of gestation.
"Implementing IADPSG recommendations will substantially increase GDM diagnosis," the authors write. "Risk-stratification in IADPSG-positive women may reduce over-treatment. Screening with FPG or BMI may be a practical alternative."