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. 2023 Dec;60(12):1663-1673.
doi: 10.1007/s00592-023-02148-2. Epub 2023 Jul 18.

Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk

Cathrine Munk Scheuer  1 , Dorte Møller Jensen  2   3   4 , H David McIntyre  5 , Lene Ringholm  6 , Elisabeth Reinhardt Mathiesen  6   7 , Celina Pforr Korsgård Nielsen  8 , Rúna Louise Mortansdóttir Nolsöe  9 , Julie Milbak  8 , Thore Hillig  10 , Peter Damm  7   11 , Martin Overgaard  4   12 , Tine Dalsgaard Clausen  8   11
Affiliations

Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk

Cathrine Munk Scheuer et al. Acta Diabetol. 2023 Dec.

Abstract

Aims: To estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds.

Methods: Diagnostic testing was performed by a 75 g oral glucose tolerance test (OGTT) at 24-28 weeks' gestation in a cohort of pregnant women. GDM diagnosis was based on the current Danish criterion (2-h glucose ≥ 9.0 mmol/L, GDMDK) and on the WHO2013 criteria (fasting ≥ 5.1, 1 h ≥ 10.0 or 2 h glucose ≥ 8.5 mmol/L, GDMWHO2013). Currently untreated women fulfilling the WHO2013 but not the Danish diagnostic criteria were defined as New-GDM-women (GDMWHO2013-positive and GDMDK-negative). Adverse outcomes risks were calculated using logistic regression.

Results: OGTT was completed by 465 women at a median of 25.7 weeks' gestation. GDMDK prevalence was 2.2% (N = 10) and GDMWHO2013 21.5% (N = 100). New-GDM was present in 19.4% (N = 90), of whom 90.0% had elevated fasting glucose. Pregnancies complicated by New-GDM had higher frequencies of pregnancy-induced hypertension (13.3% vs 4.1%, p = 0.002), large-for-gestational-age infants (22.2% vs 9.9%, p = 0.004), neonatal hypoglycaemia (8.9% vs 1.9%, p = 0.004) and neonatal intensive care unit admission (16.7% vs 5.8%, p = 0.002) compared to pregnancies without GDM.

Conclusions: GDM prevalence increased tenfold when applying WHO2013 criteria in a Danish population, mainly driven by higher fasting glucose levels. Untreated GDM in the gap between the current Danish and the WHO2013 diagnostic criteria resulted in higher risks of adverse pregnancy outcomes.

Keywords: Diagnosis; Gestational diabetes mellitus; IADPSG; Outcomes; Prevalence; WHO.

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Conflict of interest statement

The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

Figures

Fig. 1
Fig. 1
Flowchart of study design and participation rates. OGTT: oral glucose tolerance test
Fig. 2
Fig. 2
Odds ratios for adverse outcomes in New-GDM-women compared to No-GDM-women. Pregnancy-induced hypertension was adjusted for maternal BMI, age and chronic hypertension; large-for-gestational-age for maternal BMI, country of origin, educational level, smoking, parity and infant sex; neonatal hypoglycaemia for maternal BMI; and neonatal intensive care unit admission for maternal BMI and age
See this image and copyright information in PMC

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