Applying WHO2013 diagnostic criteria for gestational diabetes mellitus reveals currently untreated women at increased risk

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Aims: To estimate the prevalence of gestational diabetes mellitus (GDM) in a Danish cohort comparing the current Danish versus the WHO2013 diagnostic criteria, and to evaluate adverse pregnancy outcomes among currently untreated women in the gap between the diagnostic thresholds. Methods: Diagnostic testing was performed by a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks’ gestation in a cohort of pregnant women. GDM diagnosis was based on the current Danish criterion (2-h glucose ≥ 9.0 mmol/L, GDMDK) and on the WHO2013 criteria (fasting ≥ 5.1, 1 h ≥ 10.0 or 2 h glucose ≥ 8.5 mmol/L, GDMWHO2013). Currently untreated women fulfilling the WHO2013 but not the Danish diagnostic criteria were defined as New-GDM-women (GDMWHO2013-positive and GDMDK-negative). Adverse outcomes risks were calculated using logistic regression. Results: OGTT was completed by 465 women at a median of 25.7 weeks’ gestation. GDMDK prevalence was 2.2% (N = 10) and GDMWHO2013 21.5% (N = 100). New-GDM was present in 19.4% (N = 90), of whom 90.0% had elevated fasting glucose. Pregnancies complicated by New-GDM had higher frequencies of pregnancy-induced hypertension (13.3% vs 4.1%, p = 0.002), large-for-gestational-age infants (22.2% vs 9.9%, p = 0.004), neonatal hypoglycaemia (8.9% vs 1.9%, p = 0.004) and neonatal intensive care unit admission (16.7% vs 5.8%, p = 0.002) compared to pregnancies without GDM. Conclusions: GDM prevalence increased tenfold when applying WHO2013 criteria in a Danish population, mainly driven by higher fasting glucose levels. Untreated GDM in the gap between the current Danish and the WHO2013 diagnostic criteria resulted in higher risks of adverse pregnancy outcomes.

Original languageEnglish
JournalActa Diabetologica
Issue number12
Pages (from-to)1663-1673
Number of pages11
Publication statusPublished - 2023

Bibliographical note

Funding Information:
Open access funding provided by Royal Library, Copenhagen University Library. This work was supported by a research grant from the Danish Diabetes Academy, which is funded by the Novo Nordisk Foundation, grant number NNF17SA0031406, by Jascha Fonden, Nordsjællands Hospital, the Research Fund of the Capital Region of Denmark, Steno Diabetes Center Odense, The Research Fund of the Danish Medical Association, Frimodt-Heineke Fonden, and Tvergaards Fond.

Publisher Copyright:
© 2023, The Author(s).

    Research areas

  • Diagnosis, Gestational diabetes mellitus, IADPSG, Outcomes, Prevalence, WHO

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