Abstract
Introduction. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable degree with onset or recognition during pregnancy. As prevalence of diabetes is linked to impaired glucose tolerance during antenatal period, routine antenatal screening of GDM is required. However, screening tests for GDM remain controversial. Objective. To review different diagnostic criteria for GDM. Materials and Methods. Freely accessible, full-text articles from 1964 to 2015, available in PubMed in English language, pertaining to screening of GDM were reviewed. Results. First diagnostic criteria for GDM in 1964 by O'Sullivan and Mahan, modified by the National Diabetes Data Group (NDDG) in 1979 and Carpenter in 1982. The cut-off value as per WHO definition of GDM was 140 mg/dL, 2 hours after 75 g glucose intake. Diabetes in Pregnancy Study Group India (DIPSI), in 2006, endorsed WHO criteria but irrespective of the last meal timings. Being cost-effective, it formed the basis of national guidelines for Indians in 2014. Conclusions. As typical clinical scenarios are usually varied, practical guidelines that meet the constraints of low-resource settings like India are required.
Highlights
Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable degree with onset or recognition during pregnancy
Though the number of live births affected by hyperglycaemia in pregnancy has decreased slightly from 21.4 million to 20.9 million in 2015, the adverse perinatal outcomes in 85.1% of cases are still due to GDM, 7.4% due to other types of diabetes first diagnosed in pregnancy, and the remaining 7.5% of cases due to diabetes detected prior to pregnancy [1]
In 1964, O’Sullivan and Mahan, realizing that pregnancy had measurable effects on the metabolism of carbohydrates, gave guidelines for the diagnostic criteria of GDM based on their results performed on 752 pregnant women by 3-hour 100 g oral glucose tolerance test (OGTT) [13]
Summary
Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable degree with onset or recognition during pregnancy. As per the International Diabetes Federation (IDF), Diabetes Atlas 2015, one in seven births are affected by GDM [1]. India, being the second leading dweller of diabetic subjects (69.2 million), has become the “diabetes capital of the world” harbouring around four million women with GDM alone [2]. IDF 2013 estimated a total of 21.4 million live births to be affected with hyperglycaemia in pregnancy [3]. Though the number of live births affected by hyperglycaemia in pregnancy has decreased slightly from 21.4 million to 20.9 million in 2015, the adverse perinatal outcomes in 85.1% of cases are still due to GDM, 7.4% due to other types of diabetes first diagnosed in pregnancy, and the remaining 7.5% of cases due to diabetes detected prior to pregnancy [1]
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