Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population In populations at high risk of gestational diabetes mellitus (GDM), screening every pregnant woman by an oral glucose tolerance test (OGTT) is very demanding. The aim of this study was to determine the value of the fasting capillary glucose (FCG) as a screening test for GDM.FCG was measured by a plasma-correlated glucometer in 1465 pregnant women who underwent a one-step diagnostic 75-g (...) OGTT for universal screening of GDM.One hundred and ninety-six (13.4%) women had GDM as defined by the criteria of the American Diabetes Association. The area under the receiver operating characteristic curve (AUC) of the FCG was 0.83 (95% confidence interval 0.80-0.86). A FCG threshold of 4.7 mmol/l (at an acceptable sensitivity of 86.0%) independently could rule-out GDM in 731 (49.9%) women, while the FCG could rule-in GDM (100% specificity) in 16 (1.1%) additional women; therefore, approximately

Adolescent manifestations of metabolic syndrome among children born to women with gestational diabetes in a general-population birth cohort The association between maternal gestational diabetes (GDM) and manifestations of metabolic syndrome among Caucasian adolescents was studied with data from the population-based Northern Finland 1986 Birth Cohort. This is a longitudinal cohort study from early pregnancy until offspring age 16 years and includes data from a risk group-based GDM screen (...) %, 7.5%), and fasting insulin (10.20 vs. 9.30 milliunits/L, 95% CI: 5.9%, 26.0%) were higher, and homeostatic model assessment-insulin sensitivity (74.7 vs. 82.3, 95% CI: -20.6%, -5.4%) was lower in the OGDM group. These differences were similar after an additional adjustment for birth weight and gestational age. The differences in waist circumference, insulin, and homeostatic model assessment-insulin sensitivity were attenuated but remained statistically significant after additional adjustment

Iron supplement in pregnancy and development of gestational diabetes--a randomised placebo-controlled trial To test the hypothesis that iron supplement from early pregnancy would increase the risk of gestational diabetes mellitus (GDM).Randomised placebo-controlled trial.A university teaching hospital in Hong Kong.One thousand one hundred sixty-four women with singleton pregnancy at less than 16 weeks of gestation with haemoglobin (Hb) level between 8 and 14 g/dl and no pre-existing diabetes (...) weeks (OR: 1.04, 95% confidence interval [CI]: 0.7-1.53 at 90% power) or 36 weeks. Maternal Hb and ferritin levels were higher in the iron supplement group at delivery (P < 0.001 and P= 0.003, respectively). Elective caesarean section rate was lower in the iron supplement group (OR: 0.58, 95% CI: 0.37-0.89). Infant birthweight was heavier (P= 0.001), and there were fewer small-for-gestational-age babies in the iron supplement group (OR: 0.46, 95% CI: 0.24-0.85).Iron supplement from early pregnancy

Gestational Diabetes Mellitus as a Herald of Type 2 Diabetes Mellitus: An Opportunity for a Lifetime 19465213 2009 06 08 2018 11 13 1474-547X 373 9677 2009 May 23 Lancet (London, England) Lancet Gestational diabetes mellitus: an opportunity of a lifetime. 1738-40 10.1016/S0140-6736(09)60958-2 Bentley-Lewis Rhonda R Brigham and Women's Hospital, Division of Endocrinology, Diabetes, and Hypertension, Boston, MA 02115, USA. rbentleylewis@partners.org eng K23 RR023333 RR NCRR NIH HHS United States (...) K23 RR023333-02 RR NCRR NIH HHS United States L32 MD001077 MD NIMHD NIH HHS United States L32 MD001077-03 MD NIMHD NIH HHS United States Comment Journal Article England Lancet 2985213R 0140-6736 AIM IM Lancet. 2009 Aug 29;374(9691):684 19716959 Lancet. 2009 May 23;373(9677):1773-9 19465232 Cohort Studies Diabetes Mellitus, Type 2 epidemiology etiology prevention & control Diabetes, Gestational epidemiology etiology prevention & control Female Health Services Needs and Demand Humans Incidence

Gestational diabetes: the need for a common ground. Gestational diabetes mellitus is a substantial and growing health concern in many parts of the world. Certain populations are especially vulnerable to developing this condition because of genetic, social, and environmental factors. Gestational diabetes has serious, long-term consequences for both baby and mother, including a predisposition to obesity, metabolic syndrome, and diabetes later in life. Early detection and intervention can greatly (...) improve outcomes for women with this condition and their babies. Unfortunately, screening and diagnostic tests are not uniform worldwide, which could lead not only to underdiagnosis but also undermanagement of the illness. Here, we report the controversies surrounding the causes, screening, diagnosis, management, and prevention of gestational diabetes, and give specific recommendations for research studies to address the major issues of this medical condition.

Teratogenicity associated with pre-existing and gestational diabetes. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National

Interpregnancy weight gain and cesarean delivery risk in women with a history of gestational diabetes Along with the rising prevalence of obesity, rates of gestational diabetes mellitus (GDM) and associated adverse outcomes also have increased. We conducted a population-based, retrospective cohort study to assess the association of weight gain between pregnancies with cesarean delivery for the subsequent pregnancy among women with a history of GDM.Using linked birth-certificate data for women

Screening for gestational diabetes Executive Summary IQWiG Reports – Commission No. S07-01 Screening for gestational diabetes 1 1 Translation of the executive summary of the final report “Screening auf Gestationsdiabetes” (Version 1.1; Status: 25.08.2009). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. Executive summary of final report S07-01 Screening (...) for gestational diabetes Version 1.1 25.08.2009 Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Assessing the benefit and medical necessity of screening for gestational diabetes Contracting agency: Federal Joint Committee Commission awarded on: 10.05.2007 Internal Commission No.: S07-01 Publisher’s address: Institute for Quality and Efficiency in Health Care Dillenburger Str. 27 51105 Cologne Germany Tel.: +49 221 35685-0 Fax: +49 221 35685-1 berichte@iqwig.de

A multicenter, randomized trial of treatment for mild gestational diabetes. It is uncertain whether treatment of mild gestational diabetes mellitus improves pregnancy outcomes.Women who were in the 24th to 31st week of gestation and who met the criteria for mild gestational diabetes mellitus (i.e., an abnormal result on an oral glucose-tolerance test but a fasting glucose level below 95 mg per deciliter [5.3 mmol per liter]) were randomly assigned to usual prenatal care (control group (...) %). Treatment of gestational diabetes mellitus, as compared with usual care, was also associated with reduced rates of preeclampsia and gestational hypertension (combined rates for the two conditions, 8.6% vs. 13.6%; P=0.01).Although treatment of mild gestational diabetes mellitus did not significantly reduce the frequency of a composite outcome that included stillbirth or perinatal death and several neonatal complications, it did reduce the risks of fetal overgrowth, shoulder dystocia, cesarean delivery

A blood pressure before and during early pregnancy is associated with an increased risk of gestational diabetes mellitus While women with prior gestational diabetes mellitus (GDM) are more likely to display features of the metabolic syndrome, including hypertension, in the years after delivery, it is unclear whether these components are also present before pregnancy. We examined the relationship between blood pressure (BP) measured before and during early pregnancy (<20 weeks) and the risk (...) of GDM in a nested case-control study.Case (n = 381) and control (n = 942) subjects were selected from a cohort of women delivering between 1996 and 1998 and screened for GDM between 24 and 28 weeks' gestation. GDM was defined by the National Diabetes Data Group criteria. BP and covariates data were obtained by review of the medical records. Women were categorized according to BP levels recommended by the American Heart Association outside of pregnancy: <120/80 mmHg (normal), 120-139/80-89 mmHg

Gestational Weight Gain and Gestational Diabetes Mellitus: Perinatal Outcomes To examine the association between gestational weight gain and perinatal outcome in women with gestational diabetes mellitus (GDM).This is a retrospective cohort study of women with nonanomalous singleton pregnancies with GDM enrolled in the Sweet Success California Diabetes and Pregnancy Program between 2001 and 2004. Gestational weight gain, calculated from prepregnancy weight and weight at last prenatal Sweet (...) Success visit, was subgrouped into below, within, and above the Institute of Medicine (IOM) weight-gain guidelines. Perinatal outcomes were examined using chi2 test and multivariable regression analysis with 15-35-lb weight gain as the reference group.There were 31,074 women meeting study criteria. Compared with women with gestational weight gain within the IOM guidelines, women who gained above the guidelines had higher odds of having large for gestational age neonates (adjusted odds ratio [aOR] 1.72

Standards of medical care in diabetes. III. Detection and diagnosis of gestational diabetes mellitus (GDM). Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines

Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Update of 2003 U.S. Preventive Services Task Force (USPSTF) recommendation about screening for gestational diabetes.The USPSTF weighed the evidence on maternal and neonatal benefits (reduction in preeclampsia, mortality, brachial plexus injury, clavicular fractures, admission to the neonatal intensive care unit for serious illnesses) and harms (physical and psychological harms (...) ) of screening for gestational diabetes identified for their 2003 recommendation and the accompanying systematic review of articles published since the 2003 review for screening after 24 weeks' gestation. Additional searches were performed for evidence published from 1966 to 1999 on screening before 24 weeks.Current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes mellitus, either before or after 24 weeks' gestation. (I statement.).

High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia The role of intrauterine hyperglycemia and future risk of type 2 diabetes in human offspring is debated. We studied glucose tolerance in adult offspring of women with either gestational diabetes mellitus (GDM) or type 1 diabetes, taking the impact of both intrauterine hyperglycemia and genetic predisposition to type 2 (...) diabetes into account.The glucose tolerance status following a 2-h 75-g oral glucose tolerance test (OGTT) was evaluated in 597 subjects, primarily Caucasians, aged 18-27 years. They were subdivided into four groups according to maternal glucose metabolism during pregnancy and genetic predisposition to type 2 diabetes: 1) offspring of women with diet-treated GDM (O-GDM), 2) offspring of genetically predisposed women with a normal OGTT (O-NoGDM), 3) offspring of women with type 1 diabetes (O-type 1

Metformin versus insulin for the treatment of gestational diabetes. Metformin is a logical treatment for women with gestational diabetes mellitus, but randomized trials to assess the efficacy and safety of its use for this condition are lacking.We randomly assigned 751 women with gestational diabetes mellitus at 20 to 33 weeks of gestation to open treatment with metformin (with supplemental insulin if required) or insulin. The primary outcome was a composite of neonatal hypoglycemia (...) outcomes did not differ significantly between the groups. There were no serious adverse events associated with the use of metformin.In women with gestational diabetes mellitus, metformin (alone or with supplemental insulin) is not associated with increased perinatal complications as compared with insulin. The women preferred metformin to insulin treatment. (Australian New Zealand Clinical Trials Registry number, 12605000311651.).Copyright 2008 Massachusetts Medical Society.

Screening for gestational diabetes mellitus Screening for gestational diabetes mellitus Screening for gestational diabetes mellitus Hillier T, Vesco K, Whitlock E, Pettitt D, Pedula K, Beil T Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Hillier T, Vesco K, Whitlock E, Pettitt D, Pedula K, Beil T. Screening for gestational diabetes (...) be to detect previously unrecognized diabetes (GDM is defined as onset or first recognition of diabetes during pregnancy). Therefore, more research is needed before this question can be evaluated. A recent good-quality randomized controlled trial reported that treatment of screen-detected women with mild GDM diagnosed after 24 weeks gestation reduces both maternal and composite neonatal health outcomes, without apparent harm—as reported in this RCT and in several other observational studies. Project page

Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes Nicholson W K, Wilson L M, Witkop C T, Baptiste-Roberts K, Bennett W L, Bolen S, Barone B B, Golden S H, Gary T L, Neale D M, Bass E B CRD summary This review assessed treatment, delivery (...) options and subsequent testing for type-2 diabetes for women with gestational diabetes. The authors concluded that there was insufficient evidence to recommend insulin alternatives or to formulate delivery guidelines and the 75-gm OGTT test should be retained for post-partum testing. This was a well-conducted review. The conclusions reflected the limited evidence accurately and are likely to be reliable. Authors' objectives Identified objectives were: to determine the efficacy and safety of oral

The role of exercise in preventing and treating gestational diabetes: a comprehensive review and recommendations for future research The role of exercise in preventing and treating gestational diabetes: a comprehensive review and recommendations for future research The role of exercise in preventing and treating gestational diabetes: a comprehensive review and recommendations for future research DiNallo J M, Downs D S CRD summary The authors concluded that exercise may have positive (...) and protective effects for the treatment and prevention of GDM (gestational diabetes mellitus). In view of poor reporting in the review, the small number of controlled studies, failure to assess or address heterogeneity between the studies and failure to systematically assess study quality, it is impossible to determine the reliability of the conclusions. Authors' objectives To assess the effects of exercise for treating, preventing or delaying GDM. Searching PsycLit, MEDLINE, Dissertation Abstracts Online

Screening for gestational diabetes mellitus Screening for gestational diabetes mellitus Screening for gestational diabetes mellitus Hillier T A, Vesco K K, Whitlock E P, Pettitt D J, Pedula K L, Beil T L CRD summary The authors of this well-conducted review concluded that the limited evidence about early (<24 weeks) gestational diabetes mellitus (GDM) indicates a need for more research. The conclusion, which was based on one recent good-quality study in which screening identified women (...) with mild GDM after 24 weeks' gestation and improved maternal and neonatal outcomes, is likely to be reliable. Authors' objectives To evaluate the benefits and harms of screening for gestational diabetes mellitus (GDM). Searching MEDLINE, the Cochrane CENTRAL Register, the Cochrane Database of Systematic Reviews, DARE, HTA and the National Institute for Health and Clinical Excellence were searched from 2000 to September 2006l the search terms were reported. In addition, the reference lists from

Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes Nicholson WK, Wilson LM, Witkop CT, Baptiste-Roberts K, Bennett WL, Bolen S, Barone BB, Golden SH, Gary TL, Neale DM, Bass EB Citation Nicholson WK, Wilson LM, Witkop CT, Baptiste-Roberts K (...) , Bennett WL, Bolen S, Barone BB, Golden SH, Gary TL, Neale DM, Bass EB. Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes. Rockville: Agency for Healthcare Research and Quality (AHRQ). Evidence Report/Technology Assessment No. 162. 2008 Authors' objectives

We focused on four questions: (1) What are the risks and benefits of an oral diabetes agent (i.e., glyburide), as compared to all types of insulin, for gestational diabetes? (2) What