Issue 139 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