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Item #10
New
Diagnostic Criteria For Gestational Diabetes
Diagnosis
should be based on maternal post-natal carbohydrate tolerance.
Current
World Health Organization guidelines on maternal post-natal glucose
tolerance should be the basis of diagnosis of gestational diabetes in
women from ethnic minorities.
The diagnosis should be based on maternal post-natal carbohydrate
tolerance at the recommended level of 140mg/Dl or 7.8 mmol/L two hours
after a 75 gram glucose load, say specialists at the Central Middlesex
Hospital, London, England.
This conclusion was reached after researchers compared this
recommended value in 101 women (Group A) to a two-hour value of
162-198mg/Dl or 9.0-11.0 mmol/L in 71 women (Group B) of similar age,
parity, gestational age and infants born.
The ethnic make-up of the two groups was also similar, comprising 7 to
11 white, 37 to 57 Asian, 25 to 26 black and 1 to 8 Mediterranean
women.
No women from group A and one (1.4 %) from group B (Asian) had
diabetes post-partum. Eight (7.9 %) from group A (three Asian, five
black) and eight (11.2 %) from group B (six Asian, one black, one
white) had impaired glucose tolerance. Three (2.9%) from group A (one
Asian, one black, one white) and one (1.4%) from group B (Asian) had
impaired fasting glucose.
Further oral glucose tolerance tests in those women with impaired
post-partum glucose tolerance showed that three in group A reverted to
normal, two continued to have impaired glucose tolerance and one
developed diabetes, while two were lost to follow-up.
In group B, two reverted to normal, three continued to have impaired
glucose tolerance and one developed diabetes, while two were lost to
follow-up.
In those with impaired fasting glucose post-natally, all three women
from group A developed diabetes while the one from group B remained
normal.
Practical
Diabetes International 2002;19(9):279-282
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