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Current Diabetes Reviews

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ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

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Current Practice and Controversies in Screening for Gestational Diabetes

Author(s): Ritwika Mallik and M.S. Bobby Huda*

Volume 19, Issue 2, 2023

Published on: 17 August, 2022

Article ID: e130622205912 Pages: 7

DOI: 10.2174/1573399819666220613154802

Price: $65

Abstract

Gestational diabetes mellitus (GDM) is associated with fetal and maternal complications, and the prevalence has been increasing over the past decades. Hence, it is imperative to effectively screen, manage and monitor patients with GDM, but there continues to be a lack of consensus on optimal screening for GDM internationally. In this review, we discuss the current screening methods for GDM, some of which are controversial and vary across several different healthcare systems. We also discuss the changes adapted to these guidelines during the COVID-19 pandemic and review novel approaches to the screening of GDM.

Keywords: Gestational diabetes, screening, glucose intolerance, GDM, COVID-19, dyslipidaemia.

[1]
Metzger BE, Coustan DR. Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 1998; 21 (Suppl. 2): B161-7.
[PMID: 9704245]
[2]
Dashora U, Temple R, Murphy H, et al. Management of glycaemic control in pregnant women with diabetes on obstetric wards and delivery units 2017. Available from: http://www.diabetologists-abcd.org.uk/JBDS/JBDS_Pregnancy_201017.pdf (Accessed on 6 September 2021).
[3]
Mustafa M, Bogdanet D, Khattak A, et al. Early gestational diabetes mellitus (GDM) is associated with worse pregnancy outcomes compared with GDM diagnosed at 24-28 weeks gestation despite early treatment. QJM 2021; 114(1): 17-24.
[http://dx.doi.org/10.1093/qjmed/hcaa167] [PMID: 32413109]
[4]
American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2020. Diabetes Care 2020; 43 (Suppl. 1): S14-31.
[http://dx.doi.org/10.2337/dc20-S002] [PMID: 31862745]
[5]
Hod M, Kapur A, Sacks DA, et al. The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet 2015; 131 (Suppl. 3): S173-211.
[http://dx.doi.org/10.1016/S0020-7292(15)30033-3]
[6]
Diabetes UKWhat is Gestational diabetes? Available from: https://www.diabetes.org.uk/diabetes-the-basics/gestational-diabetes (Accessed on 16 September 2021).
[7]
Buchanan TA. Pancreatic B-cell defects in gestational diabetes: Implications for the pathogenesis and prevention of type 2 diabetes. J Clin Endocrinol Metab 2001; 86(3): 989-93.
[http://dx.doi.org/10.1210/jcem.86.3.7339] [PMID: 11238474]
[8]
Catalano PM, Kirwan JP, Haugel-de Mouzon S, King J. Gestational diabetes and insulin resistance: Role in short- and long-term implications for mother and fetus. J Nutr 2003; 133(5) (Suppl. 2): 1674S-83S.
[http://dx.doi.org/10.1093/jn/133.5.1674S] [PMID: 12730484]
[9]
Catalano PM. Trying to understand gestational diabetes. Diabet Med 2014; 31(3): 273-81.
[http://dx.doi.org/10.1111/dme.12381] [PMID: 24341419]
[10]
Dłuski DF, Wolińska E, Skrzypczak M. Epigenetic changes in gestational diabetes mellitus. Int J Mol Sci 2021; 22(14): 7649.
[http://dx.doi.org/10.3390/ijms22147649] [PMID: 34299269]
[11]
Sferruzzi-Perri AN. Placental mitochondria central to gestational diabetes pathogenesis? J Physiol 2021; 599(4): 1019-20.
[http://dx.doi.org/10.1113/JP281041] [PMID: 33337541]
[12]
McElwain CJ, McCarthy FP, McCarthy CM. Gestational diabetes mellitus and maternal immune dysregulation: What we know so far. Int J Mol Sci 2021; 22(8): 4261.
[http://dx.doi.org/10.3390/ijms22084261] [PMID: 33923959]
[13]
Panaitescu AM, Ciobanu AM, Popa M, et al. Screening for gestational diabetes during the COVID-19 pandemic-current recommendations and their consequences. Medicina (Kaunas) 2021; 57(4): 381.
[http://dx.doi.org/10.3390/medicina57040381] [PMID: 33920937]
[14]
Saravanan P. Diabetes in pregnancy working group. Maternal medicine clinical study group; Royal College of obstetricians and gynaecologists, UK. Gestational diabetes: Opportunities for improving maternal and child health. Lancet Diabetes Endocrinol 2020; 8(9): 793-800.
[http://dx.doi.org/10.1016/S2213-8587(20)30161-3] [PMID: 32822601]
[15]
Bennewitz Heinrich G. De diabete mellito graviditatis symptomate (“Symptoms of Diabetes in Pregnancy.”) Berolini: Typis Ioannis Friderici Starckii 1824.
[16]
The clinical significance of glycosuria in pregnant women. Hospital (Lond 1886) 1910; 47(1231): 658
[17]
Rosenfeld L. Insulin: Discovery and controversy. Clin Chem 2002; 48(12): 2270-88.
[http://dx.doi.org/10.1093/clinchem/48.12.2270] [PMID: 12446492]
[18]
Mestman JH. Historical notes on diabetes and pregnancy. Endocrinologist 2002; 12: 224-42.
[http://dx.doi.org/10.1097/00019616-200205000-00010]
[19]
Lambie CG. Diabetes and pregnancy. J Obstet Gynaecol Br Emp 1926; 33: 563-606.
[http://dx.doi.org/10.1111/j.1471-0528.1926.tb12131.x]
[20]
Skipper E. Diabetes mellitus in pregnancy: A clinical and analytical study. QJM 1933; 7: 353-80.
[21]
Wilkerson HL, Remein QR. Studies of abnormal carbohydrate metabolism in pregnancy; the significance of impaired glucose tolerance. Diabetes 1957; 6(4): 324-9.
[http://dx.doi.org/10.2337/diab.6.4.324] [PMID: 13447761]
[22]
White P. Classification of obstetric diabetes. Am J Obstet Gynecol 1978; 130(2): 228-30.
[http://dx.doi.org/10.1016/0002-9378(78)90373-3] [PMID: 619663]
[23]
Metzger BE, Buchanan TA, Coustan DR, et al. Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diabetes Care 2007; 30 (Suppl. 2): S251-60.
[http://dx.doi.org/10.2337/dc07-s225] [PMID: 17596481]
[24]
Coustan DR, Lowe LP, Metzger BE, Dyer AR. International association of diabetes and pregnancy study groups. The hyperglycemia and adverse pregnancy outcome (HAPO) study: Paving the way for new diagnostic criteria for gestational diabetes mellitus. Am J Obstet Gynecol 2010; 202(6): 654.e1-6.
[http://dx.doi.org/10.1016/j.ajog.2010.04.006] [PMID: 20510967]
[25]
Metzger BE, Gabbe SG, Persson B, et al. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33(3): 676-82.
[http://dx.doi.org/10.2337/dc09-1848] [PMID: 20190296]
[26]
National Institute for Health and Care Excellence. Diabetes in pregnancy: Management of diabetes and its complications frompreconception to the postnatal period. Available from: https://www.nice.org.uk/guidance/ng3 (Accessed on: 16 September 2021).
[27]
American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2021. Diabetes Care 2021; 44 (Suppl. 1): S15-33.
[http://dx.doi.org/10.2337/dc21-S002] [PMID: 33298413]
[28]
Screening, diagnosis and treatment of gestational diabetes in New Zealand. 2022. Available from: https://www.health.govt.nz/system/files/documents/publications/screening-diagnosis-management-of-gestational-diabetes-in-nz-clinical-practive-guideline-dec14-v2.pdf (Accessed on: 28 September 2021).
[29]
van Hoorn F, Koster M, Naaktgeboren CA, et al. Prognostic models versus single risk factor approach in first-trimester selective screening for gestational diabetes mellitus: A prospective population-based multicentre cohort study. BJOG 2021; 128(4): 645-54.
[http://dx.doi.org/10.1111/1471-0528.16446] [PMID: 32757408]
[30]
Cooray SD, Thangaratinam S, Teede HJ. Prediction modelling to personalise care for gestational diabetes. BJOG 2021; 128(4): 655-6.
[http://dx.doi.org/10.1111/1471-0528.16522] [PMID: 32957165]
[31]
National Institute for Health and Care Excellence (NICE) (2015, Updated December 2020) Diabetes in pregnancy: Management from preconception to the postnatal period NG3. 2015. Available from: https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#gestational-diabetes (Accessed on 28 September 2021).
[32]
Nankervis A, McIntyre HD, Moses R. ADIPS consensus guidelines for the testing and diagnosis of gestational diabetes mellitus in Australia. 2014. Available from: https://www.adips.org/downloads/2014ADIPSGDMGuidelinesV18.11.2014_000.pdf (Accessed on 28 September 2021).
[33]
Feig DS, Berger H, Donovan L, et al. Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes and Pregnancy. Can J Diabetes 2018; 42 (Suppl. 1): S255-82. [Erratum in: Can J Diabetes. 2018 Jun;42
[http://dx.doi.org/10.1016/j.jcjd.2017.10.038]
[34]
The World Health Organization guideline. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. 2013. Available from: http://apps.who.int/iris/bitstream/10665/85975/1/WHO_NMH_MND_13.2_eng.pdf (Accessed on 10 October 2021).
[35]
Benhalima K, Mathieu C, Van Assche A, et al. Survey by the European Board and College of Obstetrics and Gynaecology on screening for gestational diabetes in Europe. Eur J Obstet Gynecol Reprod Biol 2016; 201: 197-202.
[http://dx.doi.org/10.1016/j.ejogrb.2016.04.003] [PMID: 27129745]
[36]
Davidson KW, Barry MJ, Mangione CM, et al. Screening for gestational diabetes: US preventive services task force recommendation statement. JAMA 2021; 326(6): 531-8.
[http://dx.doi.org/10.1001/jama.2021.11922] [PMID: 34374716]
[37]
Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005; 352(24): 2477-86.
[http://dx.doi.org/10.1056/NEJMoa042973] [PMID: 15951574]
[38]
Sovio U, Murphy HR, Smith GC. Accelerated fetal growth prior to diagnosis of gestational diabetes mellitus: A prospective cohort study of nulliparous women. Diabetes Care 2016; 39(6): 982-7.
[http://dx.doi.org/10.2337/dc16-0160] [PMID: 27208333]
[39]
Koos BJ, Gornbein JA. Early pregnancy metabolites predict gestational diabetes mellitus: Implications for fetal programming. Am J Obstet Gynecol 2021; 224(2): 215.e1-7.
[http://dx.doi.org/10.1016/j.ajog.2020.07.050] [PMID: 32739399]
[40]
Landon MB, Rice MM, Varner MW, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network. Mild gestational diabetes mellitus and long-term child health. Diabetes Care 2015; 38(3): 445-52.
[http://dx.doi.org/10.2337/dc14-2159] [PMID: 25414152]
[41]
Mo X, Gai Tobe R, Takahashi Y, et al. Economic evaluations of gestational diabetes mellitus screening: A systematic review. J Epidemiol 2021; 31(3): 220-30.
[http://dx.doi.org/10.2188/jea.JE20190338] [PMID: 32448822]
[42]
Hillier TA, Pedula KL, Ogasawara KK, et al. A pragmatic, randomized clinical trial of gestational diabetes screening. N Engl J Med 2021; 384(10): 895-904.
[http://dx.doi.org/10.1056/NEJMoa2026028] [PMID: 33704936]
[43]
Casey B. Gestational diabetes - On broadening the diagnosis. N Engl J Med 2021; 384(10): 965-6.
[http://dx.doi.org/10.1056/NEJMe2100902] [PMID: 33704942]
[44]
Thangaratinam S, Saravanan P, Huda MSB, Murphy HR, Williamson C. Guidance for maternal medicine in the evolving coronavirus Covid‐19 pandemic Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/2020-07-10-guidance-for-maternal-medicine.pdf (Accessed on: 16 August 2021).
[45]
Meek CL, Lindsay RS, Scott EM, et al. Approaches to screening for hyperglycaemia in pregnant women during and after the COVID-19 pandemic. Diabet Med 2021; 38(1)e14380
[http://dx.doi.org/10.1111/dme.14380] [PMID: 32750184]
[46]
Thangaratinam S, Cooray SD, Sukumar N, et al. Endocrinology in the time of COVID-19: Diagnosis and management of gestational diabetes mellitus. Eur J Endocrinol 2020; 183(2): G49-56.
[http://dx.doi.org/10.1530/EJE-20-0401] [PMID: 32454456]
[47]
Kaiafa G, Veneti S, Polychronopoulos G, et al. Is HbA1c an ideal biomarker of well-controlled diabetes? Postgrad Med J 2021; 97(1148): 380-3.
[http://dx.doi.org/10.1136/postgradmedj-2020-138756] [PMID: 32913038]
[48]
Bender W, McCarthy C, Elovitz M, Parry S, Durnwald C. Universal HbA1c screening and gestational diabetes: A comparison with clinical risk factors. J Matern Fetal Neonatal Med 2021; 1-7.
[http://dx.doi.org/10.1080/14767058.2021.1914578] [PMID: 34044736]
[49]
Barquiel B, Herranz L, Hillman N, et al. HbA1c and gestational weight gain are factors that influence neonatal outcome in mothers with gestational diabetes. J Womens Health (Larchmt) 2016; 25(6): 579-85.
[http://dx.doi.org/10.1089/jwh.2015.5432] [PMID: 26918922]
[50]
Fonseca L, Saraiva M, Amado A, et al. Third trimester HbA1c and the association with large-for-gestational-age neonates in women with gestational diabetes. Arch Endocrinol Metab 2021; 65(3): 328-35.
[http://dx.doi.org/10.20945/2359-3997000000366] [PMID: 33939909]
[51]
Brady M, Paul R, Frolova AI, et al. Neonatal outcomes associated with high HbA1c prior to delivery. Am J Obstet Gynecol 2022; 226(1): S557-8.
[http://dx.doi.org/10.1016/j.ajog.2021.11.923]
[52]
Amaefule CE, Sasitharan A, Kalra P, et al. The accuracy of haemoglobin A1c as a screening and diagnostic test for gestational diabetes: A systematic review and meta-analysis of test accuracy studies. Curr Opin Obstet Gynecol 2020; 32(5): 322-34.
[http://dx.doi.org/10.1097/GCO.0000000000000648] [PMID: 32618746]
[53]
Liu X, Wu N, Al-Mureish A. A review on research progress in the application of glycosylated hemoglobin and glycated albumin in the screening and monitoring of gestational diabetes. Int J Gen Med 2021; 14: 1155-65.
[http://dx.doi.org/10.2147/IJGM.S296316] [PMID: 33833555]
[54]
Yew TW, Chi C, Chan SY, et al. A randomized controlled trial to evaluate the effects of a smartphone application-based lifestyle coaching program on gestational weight gain, glycemic control, and maternal and neonatal outcomes in women with gestational diabetes mellitus: The SMART-GDM Study. Diabetes Care 2021; 44(2): 456-63.
[http://dx.doi.org/10.2337/dc20-1216] [PMID: 33184151]
[55]
Jiang R, Wu S, Fang C, et al. Amino acids levels in early pregnancy predict subsequent gestational diabetes. J Diabetes 2020; 12(7): 503-11.
[http://dx.doi.org/10.1111/1753-0407.13018] [PMID: 31883199]
[56]
Okten SB. Bildacı TB. Salivary Leptin and Chemerin; a novel way of gestational diabetes screening. Gynecol Endocrinol 2020; 36(12): 1116-8.
[http://dx.doi.org/10.1080/09513590.2020.1749999] [PMID: 32274942]
[57]
Dai S, Zhu X, Xia H. MiR-2467 is a potential marker for prediction of gestational diabetes mellitus in pregnancy. Clin Lab 2020; 66(10)
[http://dx.doi.org/10.7754/Clin.Lab.2020.200233] [PMID: 33073943]

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