Does the Change in the Diagnostic Criteria for Gestational Diabetes in Poland Affect Maternal and Fetal Complications? A Prospective Study
Open accessAbstract
Background and objectives: Gestational diabetes mellitus (GDM) is a significant risk factor of maternal and fetal complications. The aim of the study was to compare two groups of patients with GDM treated in 2015/2016 (Group-15/16), and in 2017/2018 (Group-17/18) and to answer the question whether the change in the diagnostic criteria for GDM affected maternal and fetal complications. Materials and Methods: A retrospective analysis was conducted. The study included 123 patients with GDM (58 patients/Group-15/16 and 65 patients/Group-17/18). Results: No significant differences were found between the groups. In Group-17/18, GDM was significantly more often diagnosed based on fasting glycemia (33.8%) compared with Group-15/16 (22.4%; p = 0.000001). GDM was significantly more often diagnosed based on 2-h oral glucose tolerance test (OGTT; 44.8%) compared with Group-17/18 (29.2%; p = 0.000005). In Group-15/16, insulin was started in 51.7% of patients compared with 33.8% in Group-17/18 (p = 0.04287). Despite more frequent insulin therapy in Group-15/16, insulin was started later (30th week of gestation) and significantly more frequently in older patients and those with higher BMI values compared with Group-17/18 (27th week of pregnancy). The number of caesarean sections and spontaneous deliveries was also similar in both periods. No difference was found in the prevalence of neonatal complications, including neonatal hypo-glycemia, prolonged jaundice or heart defect. In addition, no differences were found between the parameters in newborns. Conclusions: The change in the criteria for the diagnosis and treatment of GDM translated into the mode of diagnosis and currently it is more often diagnosed based on abnormal fasting glycemia. Currently, a lower percentage of patients require insulin therapy. However, less frequent inclusion of insulin may result in higher postprandial glycemia in the third trimester of pregnancy in mothers, thus increasing the risk of neonatal hypoglycemia immediately after delivery.
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In Poland, more pregnant women were diagnosed with gestational diabetes mellitus based on the fasting glucose level.
“A study performed by Cichocka and Gumprecht found that more pregnant women were diagnosed with GDM based on the fasting glucose level [102].”
From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [102]
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Cites
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“Environmental factors, including particularly the obesity epidemic and higher age of pregnant women, are also involved in the manifestation of the disease [3].”
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Evolution of Gestational Diabetes Mellitus across Continents in 21st Century
Dłuski, D. F., Ruszała, M., Rudziński, G., Pożarowska, K., Brzuszkiewicz, K., & Leszczyńska-Gorzelak, B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315804 · Cited by 41 · see citing works
“A study performed by Cichocka and Gumprecht found that more pregnant women were diagnosed with GDM based on the fasting glucose level [102].”
- Authors
- Cichocka, E., & Gumprecht, J.
- Affiliations
- Medical University of Silesia (PL)
- Corresponding author
- Cichocka, Edyta
- Venue
- Medicina
- Publisher
- MDPI AG
- Published
- 2022-03-07
- Volume
- 58
- Issue
- 3
- Pages
- 398
- ISSN
- 1010-660X (ISSN-L)
- 1648-9144
- PMC
- PMC8952645
- OpenAlex
- W4220831241
- Cited by
- 3
- References
- 4
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 1
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Medicina (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Keywords
- gestational diabetes mellitus, diagnostic criteria, fasting blood glucose, oral glucose tolerance test, insulin therapy, maternal complications, fetal complications, neonatal hypoglycemia, cesarean section, postprandial blood glucose, Poland, maternal age, maternal body mass index, neonatal outcomes, congenital heart disease
- MeSH terms
- Aged, Female, Glucose Tolerance Test, Humans, Infant, Newborn, Poland, Pregnancy, Prospective Studies, Retrospective Studies, Diabetes, Gestational
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