Research Article 
The impact of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) fasting glucose diagnostic criterion on the prevalence and outcomes of gestational diabetes mellitus in Han Chinese women
S. Liao, J. Mei, W. Song, Y. Liu, Y.-D. Tan, S. Chi, P. Li, X. Chen and S. Deng
Diabetic Medicine, 2014, 31(3), 341-351. DOI: 10.1111/dme.12349
Abstract
Aims
The International Association of Diabetes and Pregnancy Study Groups (IADPSG) proposed that a one-time value of fasting plasma glucose of 5.1 mmol/l or over at any time of the pregnancy is sufficient to diagnose gestational diabetes. We evaluated the repercussions of the application of this threshold in pregnant Han Chinese women.
Methods
This is a retrospective study of 5360 (72.3% of total) consecutively recruited pregnant Han Chinese women in one centre from 2008 to 2011. These women underwent a two-step gestational diabetes diagnostic protocol according to the previous American Diabetes Association criteria. The IADPSG fasting plasma glucose criterion was used to reclassify these 5360 women. The prevalence, clinical characteristics and obstetric outcomes were compared among the women classified as having gestational diabetes by the previous American Diabetes Association criteria (approximately 90% were treated), those reclassified as having gestational diabetes by the single IADPSG fasting plasma glucose criterion (untreated), but not as having gestational diabetes by the previous American Diabetes Association criteria, and those with normal glucose tolerance.
Results
There were 626 cases of gestational diabetes defined by the previous American Diabetes Association criteria (11.7%) and these cases were associated with increased risks of maternal and neonatal outcomes when compared with the women with normal glucose tolerance. With the IADPSG fasting plasma glucose criterion, another 1314 (24.5%) women were reclassified as having gestational diabetes. Gestational diabetes classified by the IADPSG fasting plasma glucose criterion was associated with gestational hypertension (P = 0.0094) and neonatal admission to nursery (P = 0.035) prior to adjustment for maternal age and BMI, but was no longer a predictor for adverse pregnancy outcomes after adjustment.
Conclusion
The simple IADPSG fasting plasma glucose criterion increased the Chinese population with gestational diabetes by 200%. The increased population with gestational diabetes was not significantly associated with excess obstetric and neonatal morbidity.
ASCI-ID: 109-1465
Similar Articles
Prevalence of diabetes in Malaysia and usefulness of HbA1c as a diagnostic criterion
Diabetic Medicine, 2013, 30(7), 825-828. DOI: 10.1111/dme.12161
Diagnostic thresholds for gestational diabetes and their impact on pregnancy outcomes: a systematic reviewDiabetic Medicine, 2014, 31(3), 319-331. DOI: 10.1111/dme.12357
Aging is associated with increased HbA1c levels, independently of glucose levels and insulin resistance, and also with decreased HbA1c diagnostic specificityDiabetic Medicine, 2014, 31(8), 927-935. DOI: 10.1111/dme.12459
The implications of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria for gestational diabetesDiabetic Medicine, 2011, 28(4), 382-385. DOI: 10.1111/j.1464-5491.2011.03236.x
Examining the Behaviour subscale of the Hypoglycaemia Fear Survey: an international studyDiabetic Medicine, 2013, 30(5), 603-609. DOI: 10.1111/dme.12129