Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
Using the American Diabetes Association’s recommended thresholds for diagnosing gestational diabetes yields a 50 percent higher prevalence rate than found using previously recommended criteria. In 2000, the American Diabetes Association proposed the adoption of the Carpenter and Coustan criteria for diagnosing gestational diabetes. The Carpenter and Coustan cut-offs are lower than the previously recommended National Diabetes Data Group values and were expected to result in a higher prevalence of gestational diabetes.
Ferrara A, Hedderson and colleagues at Kaiser Permanente in Oakland, California, United States, conducted a study to estimate the magnitude of change in prevalence of gestational diabetes by age and ethnicity using the Carpenter and Coustan thresholds, compared with the National Diabetes Data Group values.
Their cross-sectional study involved 28,330 women aged 14 to 49 years, who gave birth in 1996 and were members of the Northern California Kaiser Permanente Medical Care Program.
The women’s age, ethnicity, screening, and diagnostic test results were assessed from computerized hospitalization and laboratory systems. A total of 26,481 women (94 percent) were screened using a 50-g, 1-hour oral glucose tolerance test, and 4,190 of the women who had abnormal screening results underwent a diagnostic 100-g, 3-hour oral glucose tolerance test.
The gestational diabetes prevalence among screened women was 3.2 percent by National Diabetes Data Group thresholds and 4.8 percent using the Carpenter and Coustan criteria, the investigators reported.
The age-adjusted gestational diabetes prevalence for Asian women was 5.0 percent by National Diabetes Data Group criteria and 7.4 percent using Carpenter and Coustan thresholds. Among Hispanic women, the prevalence was 3.9 percent vs. 5.6 percent. In African-Americans it was 3.0 percent vs. 4.0 percent. Among whites, it was 2.4 percent compared with 3.8 percent.
"The prevalence of gestational diabetes increased, on average, by 50 percent with use of the Carpenter and Coustan thresholds," the researchers concluded. "Relative increments were greater in low-risk age and ethnic groups. This information would be useful for clinical settings in predicting cost of gestational diabetes based on demographic characteristics of the population." Diabetes Care 2002; 25:1625-1630