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Gestational diabetes mellitus: current screening problems

https://doi.org/10.14341/DM12727

Abstract

Gestational diabetes mellitus (GDM) is characterized as hyperglycemia, first detected during pregnancy, yet not meeting the criteria for “manifest” diabetes mellitus. GDM is one of the most common gestational complications. This pathology is associated with many adverse pregnancy outcomes, both on the part of the mother and the fetus. The problem of identifying GDM has acquired particular relevance and significance for the healthcare system at the moment due to the steady increase in the prevalence of such risk factors of GDM as obesity and late pregnancy. The history of screening and diagnosis of GDM has undergone a number of significant changes in a short time. Currently, different clinical guidelines offer different approaches to GDM screening, thus, a unified approach to identifying this pathology has not yet been formulated and adopted. The purpose of this review was to discover the current clinical guidelines for the detection of GDM at 24–28 weeks of pregnancy, including historical context of their origin and development, to describe these approaches, as well as to critically evaluate them with a discussion of the main advantages and disadvantages of each of them.

About the Authors

N. I. Volkova
Rostov State Medical University
Russian Federation

Natalya I. Volkova - MD, PhD, Professor; eLibrary SPIN: 3146-8337.

Rostov-on-Don


Competing Interests:

none



S. O. Panenko
Rostov State Medical University
Russian Federation

Stanislav O. Panenko - MD, PhD-student.

29, Nahichevansky av., 344022 Rostov-on-Don


Competing Interests:

none



References

1. Dedov II, Shestakova MV, Mayorov AYu et al. Standards of specialized diabetes care. Diabetes Mellitus. 2019;22(S1):1-144 (In Russ.). doi: https://doi.org/10.14341/DM221S1

2. Garrison A. Screening, diagnosis, and management of gestational diabetes mellitus. Am Fam Physician. 2015;91(7):460-467.

3. International Diabetes Federation. IDF Diabetes Atlas, 9идеяth edn. Brussels, Belgium: International Diabetes Federation; 2019 [cited May, 2020]. Available from: https://diabetesatlas.org/data/en/indicators/14/

4. Mirghani Dirar A, Doupis J. Gestational diabetes from A to Z. World J Diabetes. 2017;8(12):489-511. doi: https://doi.org/10.4239/wjd.v8.i12.489

5. Shen Y, Jia Y, Zhou J. et al. Association of gestational diabetes mellitus with adverse pregnancy outcomes: our experience and meta-analysis. Int J Diabetes Dev Ctries. 2020;40:357-370. doi: https://doi.org/10.1007/s13410-020-00802-x

6. Fadl HE, Ostlund IK, Magnuson AF, Hanson US. Maternal and neonatal outcomes and time trends of gestational diabetes mellitus in Sweden from 1991 to 2003. Diabet Med. 2010;27(4):436-441. doi: https://doi.org/10.1111/j.1464-5491.2010.02978.x

7. Muche AA, Olayemi OO, Gete YK. Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia. BMC Pregnancy Childbirth. 2020;20(1):73. doi: https://doi.org/10.1186/s12884-020-2759-8

8. Mitanchez D, Ciangura C, Jacqueminet S. How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses. Nutrients. 2020;12(2):353. doi: https://doi.org/10.3390/nu12020353

9. Poolsup N, Suksomboon N, Amin M. Effect of Treatment of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. PLoS One. 2014;9(3):e92485. doi: https://doi.org/10.1371/journal.pone.0092485

10. Crowther CA, Hiller JE, Moss JR, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352(24):2477-2486. doi: https://doi.org/10.1056/NEJMoa042973

11. American Diabetes Association. 14. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(S1):S183-S192. doi: https://doi.org/10.2337/dc20-S014

12. Schäfer-Graf UM, Gembruch U, Kainer F, et al. Gestational Diabetes Mellitus (GDM) - Diagnosis, Treatment and Follow-Up. Guideline of the DDG and DGGG (S3 Level, AWMF Registry Number 057/008, February 2018). Geburtshilfe Frauenheilkd. 2018;78(12):1219-1231. doi: https://doi.org/10.1055/a-0659-2596

13. Richtlijn van de Nederlands Vereniging voor Obstetrie en Gynaecologie (NVOG) diabetes mellitus en zwangerschap. Versie 3.0.; 2018 [cited May, 2020]. Available from: https://www.nvog.nl/wp-content/uploads/2018/10/NVOG-richtlijn-Diabetes-mellitus-en-zwangerschap-v3.0-2018.pdf

14. Powe CE, Huston Presley LP, et al. Augmented insulin secretory response in early pregnancy. Diabetologia. 2019;62(8):1445-1452. doi: https://doi.org/10.1007/s00125-019-4881-6.

15. Catalano PM, Tyzbir ED, Roman NM, et al. Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women. Am J Obstet Gynecol. 1991;165(6 Pt 1):1667-1672. doi: https://doi.org/10.1016/0002-9378(91)90012-g

16. Kirwan JP, Huston-Presley L, et al. Clinically useful estimates of insulin sensitivity during pregnancy: validation studies in women with normal glucose tolerance and gestational diabetes mellitus. Diabetes Care. 2001;24(9):1602-1607. doi: https://doi.org/10.2337/diacare.24.9.1602

17. Bennewitz HG. De Diabete Mellito, Gravidatatis Symptomate. MD Thesis, University of Berlin; 1824

18. Mestman JH: Historical notes on diabetes in pregnancy. Endocrinologist. 2002;12(3):224-242. doi: https://doi.org/10.1097/00019616-200205000-00010

19. Duncan JM. On puerperal diabetes. Trans Obstet Soc Lond. 1882;24:256

20. Hoet JP, Lukens FD. Carbohydrate metabolism during pregnancy. Diabetes. 1954;3(1):1-12. doi: https://doi.org/10.2337/diab.3.1.1

21. Carrington ER, Shuman CR, Reardon HS. Evaluation of the prediabetic state during pregnancy. Obstet Gynecol. 1957;9(6):664-669. doi: https://doi.org/10.1097/00006250-195706000-00008

22. O’Sullivan JB, Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes. 1964;13:278-285.

23. O’Sullivan JB. Establishing criteria for gestational diabetes. Diabetes Care. 1980;3(3):437-439. doi: https://doi.org/10.2337/diacare.3.3.437

24. O’Sullivan JB, Mahan CM, Charles D, et al. Screening criteria for high-risk gestational diabetic patients. Am J Obstet Gynecol. 1973;116(7):895-900. doi: https://doi.org/10.1016/s0002-9378(16)33833-9

25. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982;144(7):768-773. doi: https://doi.org/10.1016/0002-9378(82)90349-0

26. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO Consultation. Part 1: diagnosis and classification of diabetes mellitus. Geneva, Switzerland: World Health Organization; 1999. [cited May, 2020]. Available from: https://apps.who.int/iris/bitstream/handle/10665/66040/WHO_NCD_NCS_99.2.pdf?sequence=1&isAllowed=y

27. Metzger BE, Coustan DR, Trimble ER. Hyperglycemia and Adverse Pregnancy Outcomes. Clin Chem. 2019;65(7):937-938. doi: https://doi.org/10.1373/clinchem.2019.303990

28. Coustan DR, Lowe LP, Metzger BE, Dyer AR. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. Diabetes. 2009;58(2):453-459. doi: https://doi.org/10.2337/db08-1112

29. Coustan DR, Lowe LP, Metzger BE, Dyer AR. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. Am J Obstet Gynecol. 2010;202(6):654. doi: https://doi.org/10.1016/j.ajog.2010.04.006

30. Lowe WL Jr, Scholtens DM, Kuang A, et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Gestational Diabetes Mellitus and Childhood Glucose Metabolism. Diabetes Care. 2019;42(3):372-380. doi: https://doi.org/10.2337/dc18-1646

31. Scholtens DM, Kuang A, Lowe LP, et al. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care. 2019;42(3):381-392. doi: https://doi.org/10.2337/dc18-2021

32. Diagnostic Criteria and Classification of Hyperglycaemia First Detected in Pregnancy. Geneva: World Health Organization; 2013.

33. Lee KW, Ching SM, Ramachandran V, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2018;18(1):494. doi: https://doi.org/10.1186/s12884-018-2131-4

34. Miailhe G, Kayem G, Girard G, et al. Selective rather than universal screening for gestational diabetes mellitus? Eur J Obstet Gynecol Reprod Biol. 2015;191:95-100. doi: https://doi.org/10.1016/j.ejogrb.2015.05.003

35. Adam S, Rheeder P. Screening for gestational diabetes mellitus in a South African population: Prevalence, comparison of diagnostic criteria and the role of risk factors. S Afr Med J. 2017;107(6):523-527. doi: https://doi.org/10.7196/SAMJ.2017.v107i6.12043

36. Jiménez-Moleón JJ, Bueno-Cavanillas A, Luna-del-Castillo JD, et al. Predictive value of a screen for gestational diabetes mellitus: influence of associated risk factors. Acta Obstetricia et Gynecologica Scandinavica. 2000;79(11):991-998. doi: https://doi.org/10.1080/00016340009169248

37. Alberico S, Strazzanti C, De Santo D, et al. Gestational diabetes: universal or selective screening? J Matern Fetal Neonatal Med. 2004;16(6):331-337. doi: https://doi.org/10.1080/14767050400018114

38. Baliutaviciene D, Petrenko V, Zalinkevicius R. Selective or universal diagnostic testing for gestational diabetes mellitus. Int J Gynaecol Obstet. 2002;78(3):207-211. doi: https://doi.org/10.1016/s0020-7292(02)00149-2.

39. Benhalima K, Van Crombrugge P, Moyson C, et al. Risk factor screening for gestational diabetes mellitus based on the 2013 WHO criteria. Eur J Endocrinol. 2019;180(6):353-363. doi: https://doi.org/10.1530/EJE-19-0117

40. Griffin ME, Coffey M, Johnson H, et al. Universal vs. risk factor-based screening for gestational diabetes mellitus: detection rates, gestation at diagnosis and outcome. Diabet Med. 2000;17(1):26-32. doi: https://doi.org/10.1046/j.1464-5491.2000.00214.x

41. Farrar D, Fairley L, Wright J, et al. Evaluation of the impact of universal testing for gestational diabetes mellitus on maternal and neonatal health outcomes: a retrospective analysis. BMC Pregnancy Childbirth. 2014;14:317. doi: https://doi.org/10.1186/1471-2393-14-317

42. Cosson E, Vicaut E, Sandre-Banon D, et al. Performance of a selective screening strategy for diagnosis of hyperglycaemia in pregnancy as defined by IADPSG/WHO criteria. Diabetes Metab. 2020;46(4):311-318. doi: https://doi.org/10.1016/j.diabet.2019.09.002

43. Farrar Di, Simmonds M, Bryant M, et al. Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts. PLoS One. 2017;12(4):e0175288. doi: https://doi.org/10.1371/journal.pone.0175288

44. Ogonowski J, Miazgowski T, Homa K, et al. Low predictive value of traditional risk factors in identifying women at risk for gestational diabetes. Acta Obstet Gynecol Scand. 2007;86(10):1165-1170. doi: https://doi.org/10.1080/00016340701505044

45. Helseth R, Salvesen O, Stafne SN, et al. Gestational diabetes mellitus among Nordic Caucasian women: prevalence and risk factors according to WHO and simplified IADPSG criteria. Scand J Clin Lab Invest. 2014;74(7):620-628. doi: https://doi.org/10.3109/00365513.2014.928942.

46. Muniswaran G, Soelar SA, Karalasingam SD, et al. Effectiveness of selective risk based screening for Gestational Diabetes (GDM) in Malaysia: A retrospective cohort study based on the National Obstetric Registry (NOR) of Malaysia. Med J Malaysia. 2017;72(1):46-49.

47. Sert UY, Ozgu-Erdinc AS. Gestational Diabetes Mellitus Screening and Diagnosis. In: Advances in Experimental Medicine and Biology. 2020;10:231-255. doi: https://doi.org/10.1007/5584_2020_512

48. Donovan L, Hartling L, Muise M, et al. Screening tests for gestational diabetes: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;159(2):115-122. doi: https://doi.org/10.7326/0003-4819-159-2-201307160-00657

49. Benhalima K, Van Crombrugge P, Moyson C, et al. The Sensitivity and Specificity of the Glucose Challenge Test in a Universal Two-Step Screening Strategy for Gestational Diabetes Mellitus Using the 2013 World Health Organization Criteria. Diabetes Care. 2018;41(7):e111-e112. doi: https://doi.org/10.2337/dc18-0556

50. Benhalima K, Van Crombrugge P, Moyson C, et al. A Modified Two-Step Screening Strategy for Gestational Diabetes Mellitus Based on the 2013 WHO Criteria by Combining the Glucose Challenge Test and Clinical Risk Factors. J Clin Med. 2018;7(10):351. doi: https://doi.org/10.3390/jcm7100351

51. Olagbuji BN, Aderoba AK, Kayode OO, et al. Accuracy of 50-g glucose challenge test to detect International Association of Diabetes and Pregnancy Study Groups criteria-defined hyperglycemia. Int J Gynaecol Obstet. 2017;139(3):312-317. doi: https://doi.org/10.1002/ijgo.12304

52. Van Leeuwen M, Zweers EJ, Opmeer BC, et al. Comparison of accuracy measures of two screening tests for gestational diabetes mellitus. Diabetes Care. 2007;30(11):2779-2784. doi: https://doi.org/10.2337/dc07-0571

53. Dwarakanath L, Hema KR, Hemashree P. One step procedure for screening and diagnosis of gestational diabetes mellitus by diabetes in pregnancy study group of India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019;8(8):3344-3349. doi: https://doi.org/10.18203/2320-1770.ijrcog20193563

54. Chevalier N, Fénichel P, Giaume V, et al. Universal two-step screening strategy for gestational diabetes has weak relevance in French Mediterranean women: should we simplify the screening strategy for gestational diabetes in France? Diabetes Metab. 2011;37(5):419-425. doi: https://doi.org/10.1016/j.diabet.2011.01.004

55. Wu ET, Nien FJ, Kuo CH, et al. Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria. J Diabetes Investig. 2016;7(1):121-126. doi: https://doi.org/10.1111/jdi.12378

56. Roeckner JT, Sanchez-Ramos L, Jijon-Knupp R, Kaunitz AM. Single abnormal value on 3-hour oral glucose tolerance test during pregnancy is associated with adverse maternal and neonatal outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;215(3):287-297. doi: https://doi.org/10.1016/j.ajog.2016.04.040

57. Feldman RK, Tieu RS, Yasumura L. Gestational Diabetes Screening: The International Association of the Diabetes and Pregnancy Study Groups Compared With Carpenter-Coustan Screening. Obstet Gynecol. 2016;127(1):10-17. doi: https://doi.org/10.1097/AOG.0000000000001132

58. Wu ET, Nien FJ, Kuo CH, et al. Diagnosis of more gestational diabetes lead to better pregnancy outcomes: Comparing the International Association of the Diabetes and Pregnancy Study Group criteria, and the Carpenter and Coustan criteria. J Diabetes Investig. 2016;7(1):121-126. doi: https://doi.org/10.1111/jdi.12378

59. Kim MH, Kwak SH, Kim SH, et al. Pregnancy Outcomes of Women Additionally Diagnosed as Gestational Diabetes by the International Association of the Diabetes and Pregnancy Study Groups Criteria. Diabetes Metab J. 2019;43(6):766-775. doi: https://doi.org/10.4093/dmj.2018.0192

60. Sevket O, Ates S, Uysal O, et al. To evaluate the prevalence and clinical outcomes using a one-step method versus a two-step method to screen gestational diabetes mellitus. J Matern Fetal Neonatal Med. 2014;27(1):36-41. doi: https://doi.org/10.3109/14767058.2013.799656

61. Ogunleye OK, Davidson KD, Gregg AR, Egerman RS. Perinatal outcomes after adopting 1- versus 2-step approach to diagnosing gestational diabetes. J Matern Fetal Neonatal Med. 2017;30(2):186-190. doi: https://doi.org/10.3109/14767058.2016.1166201

62. Oriot P, Selvais P, Radikov J, et al. Assessing the incidence of gestational diabetes and neonatal outcomes using the IADPSG guidelines in comparison with the Carpenter and Coustan criteria in a Belgian general hospital. Acta Clin Belg. 2014;69(1):8-11. doi: https://doi.org/10.1179/0001551213Z.0000000004

63. Costa E, Kirckpartick C, Gerday C, et al. Change in prevalence of gestational diabetes and obstetric complications when applying IADPSG screening criteria in a Belgian French speaking University Hospital. A retrospective cohort study. BMC Pregnancy Childbirth. 2019;19(1):249. doi: https://doi.org/10.1186/s12884-019-2406-4

64. Huhn EA, Massaro N, Streckeisen S, et al. Fourfold increase in prevalence of gestational diabetes mellitus after adoption of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. J Perinat Med. 2017;45(3):359-366. doi: https://doi.org/10.1515/jpm-2016-0099

65. Lucovnik M, Steblovnik L, Verdenik I, et al. Changes in perinatal outcomes after implementation of IADPSG criteria for screening and diagnosis of gestational diabetes mellitus: A national survey. Int J Gynaecol Obstet. 2020;149(1):88-92. doi: https://doi.org/10.1002/ijgo.13098

66. Duran A, Sáenz S, Torrejón MJ, et al. 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. Diabetes Care. 2014;37(9):2442-2450. doi: https://doi.org/10.2337/dc14-0179

67. Hung TH, Hsieh TT. The effects of implementing the International Association of Diabetes and Pregnancy Study Groups criteria for diagnosing gestational diabetes on maternal and neonatal outcomes. PLoS One. 2015;10(3):e0122261. doi: https://doi.org/10.1371/journal.pone.0122261

68. Hosseini E, Janghorbani M. Systematic review and meta-analysis of diagnosing gestational diabetes mellitus with one-step or two-step approaches and associations with adverse pregnancy outcomes. Int J Gynaecol Obstet. 2018;143(2):137-144. doi: https://doi.org/10.1002/ijgo.12644

69. Saccone G, Khalifeh A, Al-Kouatly HB, et al. Screening for gestational diabetes mellitus: one step versus two step approach. A meta-analysis of randomized trials. J Matern Fetal Neonatal Med. 2020;33(9):1616-1624. doi: https://doi.org/10.1080/14767058.2018.1519543

70. Saccone G, Caissutti C, Khalifeh A, et al. One step versus two step approach for gestational diabetes screening: systematic review and meta-analysis of the randomized trials. J Matern Fetal Neonatal Med. 2019;32(9):1547-1555. doi: https://doi.org/10.1080/14767058.2017.1408068

71. Li Z, Cheng Y, Wang D, et al. Incidence Rate of Type 2 Diabetes Mellitus after Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of 170,139 Women. J Diabetes Res. 2020;2020:1-12. doi: https://doi.org/10.1155/2020/3076463

72. Pan L, Leng J, Liu G, et al. Pregnancy outcomes of Chinese women with gestational diabetes mellitus defined by the IADPSG’s but not by the 1999 WHO’s criteria. Clin Endocrinol (Oxf). 2015;83(5):684-693. doi: https://doi.org/10.1111/cen.12801

73. Goedegebure EAR, Koning SH, Hoogenberg K, et al. Pregnancy outcomes in women with gestational diabetes mellitus diagnosed according to the WHO-2013 and WHO-1999 diagnostic criteria: a multicentre retrospective cohort study. BMC Pregnancy Childbirth. 2018;18(1):152. doi: https://doi.org/10.1186/s12884-018-1810-5

74. Shareef M, Saleh L, van den Meiracker AH, Visser W. The impact of implementing the WHO-2013 criteria for gestational diabetes mellitus on its prevalence and pregnancy outcomes: A comparison of the WHO-1999 and WHO-2013 diagnostic thresholds. Eur J Obstet Gynecol Reprod Biol. 2020;246:14-18. doi: https://doi.org/10.1016/j.ejogrb.2019.12.013

75. de Wit L, Zijlmans AB, Rademaker D, et al. Estimated impact of introduction of new diagnostic criteria for gestational diabetes mellitus. World J Diabetes. 2021;12(6):868-882. doi: https://doi.org/10.4239/wjd.v12.i6.868

76. Chi C, Loy SL, Chan SY, et al. Impact of adopting the 2013 World Health Organization criteria for diagnosis of gestational diabetes in a multi-ethnic Asian cohort: a prospective study. BMC Pregnancy Childbirth. 2018;18(1):69. doi: https://doi.org/10.1186/s12884-018-1707-3

77. Basri NI, Mahdy ZA, Ahmad S, et al. The World Health Organization (WHO) versus The International Association of Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria of gestational diabetes mellitus (GDM) and their associated maternal and neonatal outcomes. Horm Mol Biol Clin Investig. 2018;34(1). doi: https://doi.org/10.1515/hmbci-2017-0077

78. Mo X, Gai Tobe R, Takahashi Y, et al. Economic Evaluations of Gestational Diabetes Mellitus Screening: A Systematic Review. J Epidemiol. 2021;31(3):220-230. doi: https://doi.org/10.2188/jea.JE20190338


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Volkova N.I., Panenko S.O. Gestational diabetes mellitus: current screening problems. Diabetes mellitus. 2022;25(1):72-80. (In Russ.) https://doi.org/10.14341/DM12727

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