ABSTRACT
INTRODUCTION At the beginning of COVID epidemia, Italian Diabetes Societies advised pregnant women to not perform GDM screening with an Oral Glucose Tolerance Test (OGTT), but with a single fast glycemia value (≥92 mg/dl) at 24-28 weeks gestation. METHODS All pregnant women who performed an OGTT following IADPSG criteria and then delivered at our University Hospital from march 2020 to march 2021 were prospectively enrolled in this study. Primary outcome of the study was the number of women to whom was diagnosed GDM with only the fasting glucose value, following Italian Diabetes Society recommendations for COVID period. In the same time, we collected the data of women who became diabetic following the criteria of WHO 1999 (fast glucose value ≥120mg/dl, 2 h later ≥140mg/dl) still in use in some large countries like India. These women, who didn't meet IADPSG criteria had no treatment or glycemia monitoring. Clinical outcomes such as hypertensive disorders, preterm birth, macrosomia, intrauterine growth restriction and Caesarean section in emergency were compared between the 2 groups. RESULTS The number of women with a diagnosis of GDM in the 12-month period considered was 118. Only 77 (65%) had a fast glucose value ≥92 mg/dl thus if we had followed the Italian Diabetes Association, we lost 1/3 of GDM diagnosis. In the same period, pregnant women with a diagnosis of GDM following WHO '99 recommendations were 44. This group experienced the lowest rate of all clinical outcomes considered;furthermore, it was not monitored and not treated. CONCLUSIONS Although with limited numbers, our experience demonstrated that performing GDM diagnosis with a single value of fasting glycemia might fail for one-third of cases. The other result of the study is that is very hard to compare western studies performed with IADPGS criteria with those in which WHO '99 criteria are used, probably for the deep metabolic differences between populations considered.