evaluation of the latest ADA criteria for screening and diagnosing gestational diabetes at a tertiary care hospital in the United Arab Emirates

ABSTRACT

The American Diabetic Association [ADA] has recently recommended lowering the cut-off values for the two-step oral glucose tolerance test [OGTT] used for screening of gestational diabetes. This study reports on the appropriateness of applying the latest ADA diagnostic criteria when screening for gestational diabetes mellitus [GDM] in a tertiary care facility in the United Arab Emirates. The study was carried out at Mafraq Hospital, Abu Dhabi, United Arab Emirates [UAE] between November 1999 and April 2001. A total of 889 pregnant women who underwent at least one test of the two-step OGTT were studied retrospectively for adverse maternal and fetal outcomes. Subjects were classified as GDM positive or negative by applying the old and the latest ADA criteria and the occurrence of adverse outcomes in the various groups was compared. Applying the latest ADA criteria with the two-step OGTT identified 11% and 17% more patients at risk for fetal and maternal adverse outcomes respectively. Advanced maternal age [> 30 years in our population], multi-parity [> 4] and obesity [BMI > 30] were associated with increased risk of being diagnosed as having GDM. Application of the latest ADA criteria to the two-step OGTT was determined to be appropriate for UAE pregnant women tested for GDM in the tertiary care setting. Older [age > 30 years], multiparous [parity > 4], and obese women [BMI > 30] were at greater risk of GDM diagnosis by the latest ADA criteria