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Comment on: American Diabetes Association. Standards of Medical Care in Diabetes—2011. Diabetes Care 2011;34(Suppl. 1):S11–S61

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TLDR
The new standards set by the American Diabetes Association in 2011 recommend universal screening at 24–28 weeks of gestation and an oral glucose tolerance test with a diagnostic fasting plasma glucose of ≥92 mg/dL (4.5 mmol/L) (much lower than the World Health Organization criteria).
Abstract
How to screen and treat gestational diabetes mellitus (GDM) has always been controversial for clinicians and decision makers. The problem is complex, and the evidence is limited. The new standards set by the American Diabetes Association (ADA) in 2011 (1) recommend 1 ) universal screening at 24–28 weeks of gestation (2010 ADA standards recommended selective screening based on risk factors) and 2 ) an oral glucose tolerance test with a diagnostic fasting plasma glucose of ≥92 mg/dL (4.5 mmol/L) (much lower than the World Health Organization [WHO] criteria of ≥126 mg/dL [7.0 mmol/L] commonly used in clinical practice in Europe). Furthermore, diabetes is diagnosed when only one abnormal value is detected (whereas in the 2010 standards two …

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TL;DR: It is shown that SAT and VAT remodeling with stemness deficit is associated with early glucose metabolism impairment suggesting the benefit of an AT-target therapy controlling hypertrophy and hyperplasia already in prediabetic obese patients.
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Long-term effects of the multidisciplinary risk assessment and management program for patients with diabetes mellitus (RAMP-DM): a population-based cohort study.

TL;DR: The RAMP-DM intervention was associated with lower incidences of individual and total cardiovascular complications, as well as all-cause mortality over 3 years follow-up, providing evidence to support that the structured risk-stratification management leading by a multidisciplinary clinical team was an effective approach to reduce future cardiovascular complications in people with diabetes.
References
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Journal ArticleDOI

Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
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International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy.

TL;DR: The Brazilian study provided evidence that adverse perinatal outcomes are associated with levels of maternal glycemia below those diagnostic of GDM by American Diabetes Association or World Health Organization criteria, however, the results were potentially confounded by the treatment of G DM.
Journal ArticleDOI

Standards of Medical Care in Diabetes—2011

Vittorio Basevi
- 06 Feb 2011 - 
TL;DR: I. Screening and management of chronic complications in children and adolescents with type 1 diabetes i.e., screenings for type 2 diabetes and risk of future diabetes in adults, and strategy for improving diabetes care in the hospital, are outlined.
Journal ArticleDOI

Effect of treatment of gestational diabetes mellitus on pregnancy outcomes

TL;DR: Treatment of gestational diabetes reduces serious perinatal morbidity and may also improve the woman's health-related quality of life.
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