Introduction of IADPSG Criteria for the Screening and Diagnosis of Gestational Diabetes Mellitus Results in Improved Pregnancy Outcomes at a Lower Cost in a Large Cohort of Pregnant Women: The St. Carlos Gestational Diabetes Study
Alejandra Durán,Sofía Sáenz,María José Torrejón,Elena Bordiú,Laura del Valle,Mercedes Galindo,Noelia Perez,Miguel Herraiz,Nuria Izquierdo,Miguel A. Rubio,Isabelle Runkle,Natalia Pérez-Ferre,Idalia Cusihuallpa,Sandra Sánchez Jiménez,Nuria García de la Torre,María Dolores Robles Fernández,Carmen Montañez,Cristina Familiar,Alfonso L. Calle-Pascual +18 more
TLDR
The application of the new IADPSGC was associated with a 3.5-fold increase in GDM prevalence in the study population, as well as significant improvements in pregnancy outcomes, and was cost-effective.Abstract:
OBJECTIVE The use of the new International Association of the Diabetes and Pregnancy Study Groups criteria (IADPSGC) for the diagnosis of gestational diabetes mellitus (GDM) results in an increased prevalence of GDM. Whether their introduction improves pregnancy outcomes has yet to be established. We sought to evaluate the cost-effectiveness of one-step IADPSGC for screening and diagnosis of GDM compared with traditional two-step Carpenter-Coustan (CC) criteria.
RESEARCH DESIGN AND METHODS GDM risk factors and pregnancy and newborn outcomes were prospectively assessed in 1,750 pregnant women from April 2011 to March 2012 using CC and in 1,526 pregnant women from April 2012 to March 2013 using IADPSGC between 24 and 28 weeks of gestation. Both groups received the same treatment and follow-up regimes.
RESULTS The use of IADPSGC resulted in an important increase in GDM rate (35.5% vs. 10.6%) and an improvement in pregnancy outcomes, with a decrease in the rate of gestational hypertension (4.1 to 3.5%: −14.6%, P < 0.021), prematurity (6.4 to 5.7%: −10.9%, P < 0.039), cesarean section (25.4 to 19.7%: −23.9%, P < 0.002), small for gestational age (7.7 to 7.1%: −6.5%, P < 0.042), large for gestational age (4.6 to 3.7%: −20%, P < 0.004), Apgar 1-min score <7 (3.8 to 3.5%: −9%, P < 0.015), and admission to neonatal intensive care unit (8.2 to 6.2%: −24.4%, P < 0.001). Estimated cost savings was of €14,358.06 per 100 women evaluated using IADPSGC versus the group diagnosed using CC.
CONCLUSIONS The application of the new IADPSGC was associated with a 3.5-fold increase in GDM prevalence in our study population, as well as significant improvements in pregnancy outcomes, and was cost-effective. Our results support their adoption.read more
Citations
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Journal ArticleDOI
Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective.
Yeyi Zhu,Cuilin Zhang +1 more
TL;DR: This work comprehensively reviewed available data in the past decade in an attempt to estimate the contemporary global prevalence of gestational diabetes mellitus by country and region and the risk of progression from GDM to T2DM.
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Diabetes mellitus: The epidemic of the century
TL;DR: Despite the accumulation of extensive data at the molecular and cellular levels, the mechanism of diabetes development and complications are still not fully understood and more extensive research is needed in this field that will eventually reflect on the ultimate objective to improve diagnoses, therapy and minimize the chance of chronic complications development.
Journal ArticleDOI
Gestational Diabetes Mellitus: Mechanisms, Treatment, and Complications.
TL;DR: The most clinically and cost-effective methods of screening for GDM remain uncertain and the long-term impact for the offspring of intrauterine exposure to antidiabetic medication remains unclear.
Journal ArticleDOI
Lifestyle interventions for the treatment of women with gestational diabetes
Julie Brown,Nisreen A Alwan,Jane West,Stephen Brown,Christopher J. D. McKinlay,Diane Farrar,Caroline A Crowther +6 more
TL;DR: The effects of combined lifestyle interventions with or without pharmacotherapy in treating women with gestational diabetes were evaluated, with no clear evidence of a difference between lifestyle intervention and control groups.
Journal ArticleDOI
Prevalence of gestational diabetes mellitus in Europe: A meta-analysis.
TL;DR: This meta-analysis of primary research data reporting the prevalence of gestational diabetes mellitus in the general pregnant population of developed countries in Europe shows prevalence of GDM that is at the upper end of previous estimates in Europe.
References
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