Criteria for detecting gestational diabetes mellitus: national diabetes data group versus world health organization

ABSTRACT

Early detection of Gestational Diabetes Mellitus [GDM] and meticulous glycaemic control during the first eight weeks of pregnancy can significantly decrease the risk of congenital malformations. All pregnant women not identified as having glucose intolerance must be screened for GDM between 24-28 weeks of gestation. Diagnosis of GDM by two sets of internationally accepted criteria i.e. National Diabetes Data Group [NDDG] and World Health Organization [WHO] were compared. NDDG and WHO criteria were significantly different when compared with normal oral glucose tolerance test [OGTT] by each criteria for age, BMI, pregnancy induced hypertension, caesarian delivery, macrosomia and neonatal hypoglycaemia. A total of 709 pregnant women [24-28 weeks of gestation] were screened by 50-gm glucose screening test and 75-gm OGTT in the same week. After the 50-g glucose screening test, the blood glucose was measured after 1 hour and if found to be >= 7.8 mmol/l a diagnosis of GDM was confirmed by a 100-g OGTT within a week after a 75-g OGTT. Prevalence of GDM by NDDG criteria was 1.4%[10/709] and by WHO criteria [2 hour >= 7.8mmol/l] was 15.7% [111/709]. All those women who were diagnosed to have GDM by using NDDG criteria, had an abnormal 75-gm OGTT [WHO criteria]. Six of the 14 women with macrosomic infants had an abnormal WHO test while three of the 14 had an abnormal NDDG test. These findings suggest that WHO criteria is a better and less cumbersome criteria for the detection of GDM and all cases of GDM diagnosed by NDDG criteria were also diagnosed by WHO criteria