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المؤلفSuhail A.R., Doi
المؤلفBashir, Mohammed
المؤلفSheehan, Michael T.
المؤلفOnitilo, Adedayo A.
المؤلفChivese, Tawanda
المؤلفIbrahim, Ibrahim M.
المؤلفBeer, Stephen F.
المؤلفFuruya-Kanamori, Luis
المؤلفAbou-Samra, Abdul-Badi
المؤلفMcIntyre, H. David
تاريخ الإتاحة2021-09-16T07:53:50Z
تاريخ النشر2021-08-19
اسم المنشورPrimary Care Diabetes
المعرّفhttp://dx.doi.org/10.1016/j.pcd.2021.08.006
الاقتباسDoi, S. A., Bashir, M., Sheehan, M. T., Onitilo, A. A., Chivese, T., Ibrahim, I. M., ... & McIntyre, H. D. (2021). Unifying the diagnosis of gestational diabetes mellitus: Introducing the NPRP criteria. Primary Care Diabetes.
الرقم المعياري الدولي للكتاب17519918
معرّف المصادر الموحدhttps://www.sciencedirect.com/science/article/pii/S1751991821001406
معرّف المصادر الموحدhttp://hdl.handle.net/10576/23189
الملخصAimsDisagreement about the appropriate criteria for the diagnosis of gestational diabetes mellitus (GDM) persists. This study examines an alternative approach which combines information from all time-points on the glucose tolerance test (GTT) into a single index and expands the GDM spectrum into four categories using data from three geographically and ethnically distinct populations. MethodsA retrospective observational study design was used. Data from Wisconsin, USA (723 women) was used in derivation of the criterion and data from Doha, Qatar (1284 women) and Cape Town, South Africa (220 women) for confirmation. Pregnant women without pre-existing diabetes with a GTT done between 23 and 30 weeks gestation were included. A novel index was derived from the GTT termed the weighted average glucose (wAG). This was categorized into four pre-defined groups (henceforth National Priorities Research Program (NPRP) criterion); i) normal gestational glycemia (NGG), ii) impaired gestational glycemia (IGG), iii) GDM and iv) high risk GDM (hGDM). ResultsIn the Doha cohort, compared to the NGG group, the odds of large for gestational age babies increased 1.33 fold (P = 0.432), 2.86 fold (P < 0.001) and 3.35 fold (P < 0.001) in the IGG, GDM and hGDM groups respectively. The odds of pregnancy induced hypertension increased 2.10 fold (P = 0.024) in GDM & hGDM groups compared to the IGG and NGG groups. In the Cape Town cohort, a third of women in the GDM group and two-thirds in the hGDM group progressed to T2DM at 5 years. ConclusionsThe NPRP categorization identifies four distinct risk clusters of glycemia in pregnancy which may aid better decision making in routine management, avoid potential over-diagnosis of women at lower risk of complications and assist with diabetes prevention in women at high-risk after an index pregnancy with GDM.
اللغةen
الناشرElsevier
الموضوعGestational diabetes
Diagnostic criteria
Glucose tolerance test
Pregnancy complications
Type 2 diabetes
العنوانUnifying the diagnosis of gestational diabetes mellitus: Introducing the NPRP criteria
النوعArticle


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