Reproducibility of diabetes mellitus diagnosis (WHO 1999 criteria) in women.

Abstract

Reproducibility of diabetes mellitus (DM) diagnosis has been recognized as non-optimal and a few studies have analyzed its reproducibility using new diagnostic criteria. Our aim was to evaluate the reproducibility of WHO 1999 criteria for DM diagnosis in women. A total of 696 caucasian women with previous gestational diabetes mellitus (GDM) underwent an OGTT at a median of 6.2 years (interquartile range, 0.5-7.3) after delivery. When OGTT was diagnostic of DM, a second test was scheduled and performed after a median of 3 months (interquartile range, 1.6-10.6). At the second test, 35 women were diagnosed with DM (12 by fasting plasma glucose (FPG) alone, 10 by isolated post-challenge hyperglycemia (IPH), 10 by fasting and 2-h plasma glucose, 3 by symptoms of hyperglycemia plus measurement of plasma glucose). DM was confirmed in 56.3% of women diagnosed without symptoms. In this subgroup, reproducibility according to the abnormality at the first test was: 33.3% in those diagnosed by FPG alone, 40% in those diagnosed by IPH, and 100% in those diagnosed by both fasting and 2-h plasma glucose ( p<0.05 vs. the two previous groups). In women with former GDM, the reproducibility of DM diagnosis by FPG alone or IPH is similar and lower than the diagnosis made by abnormality in both values.