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VOLUME 7 NUMBER 4 • NOVEMBER 2010
EASD WATCH
SA JOURNAL OF DIABETES & VASCULAR DISEASE
Novo Nordisk (Pty) Ltd. Reg. No.: 1959/000833/07. PO Box 783155, Sandton, 2146. Tel: (011) 202 0500 Fax: (011) 807 7989 NN/DUO/4145/07/10/VER1
Hyperglycaemia and Adverse
Pregnancy Outcome (HAPO) study:
frequency of gestational diabetes
mellitus (GDM) at collaborating
centres based on IADPSG consensus
recommended criteria
Using the diagnostic thresholds set by the
IADPSG consensus panel, the frequency of
GDM showed significant variation between
and within regions of the world. These dif-
ferences might affect the future approach
to the diagnosis and management of GDM.
The HAPO study included almost 25 000
patients at 15 field centres from around the
globe. The aim of the original study was to
evaluate the effect of hyperglycaemia on
outcome of pregnancy. The aim of the cur-
rent study is to determine the frequency of
GDM at the HAPO study centres, according
to the new IADPSG criteria.
GDM was diagnosed in 17.8% of the
HAPO study population, but there was
great centre-to-centre variation (8.7–
23.7%) between the study participants in
maternal age, body mass index, and fre-
quency of family history of diabetes mel-
litus and hypertension. Correcting for these
differences could however not eliminate
these differences.
Analysis of pregnancies after new
IADPSG recommendation
Applying the new diagnostic criteria for
GDM as set forth by the IADPSG consensus
panel identified 2.8% more patients than
were classified as normal according to the
previous Carpenter and Coustan criteria.
The aim of the study was to evaluate
clinical and metabolic differences between
newly diagnosed GDM patients according
to the new criteria and patients that were
classified as normal by the Carpenter and
Coustan criteria.
In the new group of patients suffering
from GDM, the women were younger and
had a lower pre-pregnancy BMI. Glucose
levels as well as incidence of caesarean sec-
tion were significantly higher in this new
group. Analysis showed that there was a
significant correlation between pre-preg-
nancy BMI, basal glucose levels and the
newborn ponderal index.
A comment was made the previous cri-
teria used a 100-g OGTT, instead of the
new criteria that uses 75 g, and that this
may have affected the results.
New criteria for diagnosis of gesta-
tional diabetes mellitus in compari-
son to former diagnostic criteria
concerning maternal postpartum
glucose levels and neonatal compli-
cations
The study results support the use of the
new IADPSG criteria for the diagnosis
of GDM as it detects more women with
obstetrical risk and improves pregnancy
outcomes through treatment.
The aim of the study was to examine
whether the new diagnostic criteria for
GDM detected more women and children
at risk than the previous diagnostic criteria
used at the Fourth International Workshop
Conference of GDM (GDM-WC4).
The study was a prospective longitu-
dinal study involving 1 466 women. The
women underwent a two-hour 75-g OGTT
between 24 and 28 weeks’ gestation,
and were treated if at least one value was
exceeded, according to the GDM-WC4
criteria. The impact of different thresholds
(GDM-WC4 vs IADPSG), risk factors, foetal/
neonatal complications and maternal post-
partum glucose tolerance were evaluated.
The new criteria identified 3% more
women with GDM in comparison with
the previous criteria. The obstetrical mor-
bidity was also significantly higher in the
new GDM criteria group, with 6.1% more
large-for-gestational-age babies, 3.26%
more caesarean sections and 4.5% more
neonates with birth weight
>
4 000 g.
The rate of women detected with risk
factors increased by 2.6% using the new
criteria. There were no differences in
impaired postpartum glucose between the
two groups.
Source: oral presentations, EASD
Dr de Lange was sponsored by Sanofi Aventis to attend
the congress; Dr G Hough was sponsored by Merck.
SEMDSA/LASSA CONGRESS 2011
The 2011 SEMDSA/LASSA congress, incorporating the DESSA workshop,
will be held at the University of the Free State campus from
Saturday 9 to Monday 11 April 2011.
DESSA will hold their workshop on Saturday 9 April 2011 in parallel with SEMDSA.
Abstracts may be submitted electronically to
.
For more information and registration go to the website:
.
Deadline for registration, including abstracts is 31 January 2011.
