Potential impact of American Diabetes Association (2000) criteria for diagnosis of gestational diabetes mellitus in Spain

Diabetologia. 2005 Jun;48(6):1135-41. doi: 10.1007/s00125-005-1756-9. Epub 2005 May 12.

Abstract

Aims/hypothesis: This study was carried out to determine the impact of American Diabetes Association (ADA) 2000 criteria for the diagnosis of gestational diabetes mellitus (GDM) in the Spanish population.

Methods: Pregnant women were assigned to one of four categories: negative screenees, false-positive screenees, ADA-only-GDM (untreated) and GDM according to National Diabetes Data Group (NDDG) criteria (treated). Fetal macrosomia and Caesarean section were defined as primary outcomes, with seven additional secondary outcomes.

Results: Of 9,270 pregnant women screened for GDM, 819 (8.8%) met NDDG criteria. If the threshold for defining GDM had been lowered to ADA criteria, an additional 2.8% of women would have been defined as having the condition (relative increase of 31.8%). Maternal characteristics of women with ADA-only-GDM were between those of false-positive screenees and women with NDDG-GDM. The risk of diabetes-associated complications was slightly elevated in the individuals who would have been classified as abnormal only after the adoption of ADA criteria. In addition, the ADA-only-GDM contribution to morbidity was lower than that of other variables, especially BMI.

Conclusions/interpretation: Use of the ADA criteria to identify GDM would result in a 31.8% increase in prevalence compared with NDDG criteria. However, as the contribution of these additionally diagnosed cases to adverse GDM outcomes is not substantial, a change in diagnostic criteria is not warranted in our setting.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Apgar Score
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / epidemiology*
  • False Positive Reactions
  • Female
  • Hospitals, General
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Mass Screening
  • Middle Aged
  • Pregnancy
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Societies, Medical*
  • Spain / epidemiology
  • United States