ОLD VERSUS NEW RUSSIAN CRITERIA FOR GESTATIONAL DIABETES

Abstract

Objective. To compare the incidence of gestational diabetes mellitus (GDM), risk factors of its development when using the old (WHO, 1999) and the new Russian criteria (2012) and to assess the correspondence between fasting glycaemia and 75-g oral glucose tolerance test (OGTT), under the new criteria.Design and methods. A total of 354 pregnant women were screened for gestational diabetes mellitus by OGTT between weeks 24 and 28 of gestation. Fasting blood glucose at irst prenatal visit was obtained from the medical records. GDM for therapy initiation was diagnosed according to WHO criteria. GDM was also retrospectively deined according to the new IADPSG-criteria (fasting plasma glucose >5,1 and < 7,0 mmol/l at the irst prenatal visit or by OGTT fasting glucose >5,1 and/or ? 10,0 mmol/l after 1 hour and/or ? 8,5 mmol/l after 2 hours at 24–32 gestation week). Results. GDM was detected in 25,1 % according to the old criteria and in 26,8 % women under the new criteria by OGTT. Fasting glucose at the irst prenatal visit between 5,1 mmol/l and 7,0 mmol/l (that is, GDM under the new criteria) was deined in 92 (28,1 %) of 327 women with known fasting blood glucose level. Only in 34 (37 %) of 92 women with fasting glycemia > 5,1 mmol/l at the irst prenatal visit the results of OGTT met the criteria for GDM (IADPSG) at 24–28 weeks gestation. Total incidence of GDM according to the new criteria (at the irst prenatal visit and after 24 weeks of pregnancy) was 43,4 %. Conclusions. Application of the new Russian criteria leads to a signiicant increase in the frequency of GDM, mainly due to the fasting glucose level at the irst prenatal visit. In women with GDM, diagnosed according to the IADPSG-criteria (but not WHO), such risk factors of GDM as heredity for diabetes mellitus and hypertension before pregnancy were more often identiied compared with women without GDM.