Skip to main content
Erschienen in: Diabetologia 7/2015

01.07.2015 | Article

A proposal for the use of uniform diagnostic criteria for gestational diabetes in Europe: an opinion paper by the European Board & College of Obstetrics and Gynaecology (EBCOG)

verfasst von: Katrien Benhalima, Chantal Mathieu, Peter Damm, André Van Assche, Roland Devlieger, Gernot Desoye, Rosa Corcoy, Tahir Mahmood, Jacky Nizard, Charles Savona-Ventura, Fidelma Dunne

Erschienen in: Diabetologia | Ausgabe 7/2015

Einloggen, um Zugang zu erhalten

Abstract

Screening and diagnostic criteria for gestational diabetes (GDM) are inconsistent across Europe, and the development of a uniform GDM screening strategy is necessary. Such a strategy would create opportunities for more women to receive timely treatment for GDM. Developing a consensus on screening for GDM in Europe is challenging, as populations are diverse and healthcare delivery systems also differ. The European Board & College of Obstetrics and Gynaecology (EBCOG) has responded to this challenge by appointing a steering committee, including members of the EBCOG and the Diabetic Pregnancy Study Group (DPSG) associated with the EASD, to develop a proposal for the use of uniform diagnostic criteria for GDM in Europe. A proposal has been developed and has now been approved by the Council of the EBCOG. The current proposal is to screen for overt diabetes at the first prenatal contact using cut-off values for diabetes outside pregnancy, with particular efforts made to screen high-risk groups. When screening for GDM is performed at 24 weeks’ gestation or later, the proposal is now to use the 75 g OGTT with the new WHO diagnostic criteria for GDM. However, more research is necessary to evaluate the best GDM screening strategy for different populations in Europe. Therefore, no clear recommendation has been made on whether a universal one-step, two-step or a risk-factor-based screening approach should be used. The use of the same WHO diagnostic GDM criteria across Europe will be an important step towards uniformity.
Literatur
1.
Zurück zum Zitat O’Sullivan JB, Mahan CM (1964) Criteria for oral glucose tolerance test in pregnancy. Diabetes 13:278–285PubMed O’Sullivan JB, Mahan CM (1964) Criteria for oral glucose tolerance test in pregnancy. Diabetes 13:278–285PubMed
2.
Zurück zum Zitat Metzger BE, Buchanan TA, Coustan DR et al (2007) Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 30(Suppl 2):S251–S260CrossRefPubMed Metzger BE, Buchanan TA, Coustan DR et al (2007) Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 30(Suppl 2):S251–S260CrossRefPubMed
3.
Zurück zum Zitat Crowther CA, Hiller JE, Moss JR et al (2005) Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 352:2477–2486CrossRefPubMed Crowther CA, Hiller JE, Moss JR et al (2005) Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 352:2477–2486CrossRefPubMed
4.
Zurück zum Zitat Landon MB, Spong CY, Thom E et al (2009) A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 361:1339–1348CrossRefPubMedPubMedCentral Landon MB, Spong CY, Thom E et al (2009) A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 361:1339–1348CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358:1991–2002CrossRef HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358:1991–2002CrossRef
6.
Zurück zum Zitat Lawrence JM, Contreras R, Chen W, Sacks DA (2008) Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999-2005. Diabetes Care 31:899–904CrossRefPubMed Lawrence JM, Contreras R, Chen W, Sacks DA (2008) Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999-2005. Diabetes Care 31:899–904CrossRefPubMed
7.
Zurück zum Zitat International Association of Diabetes and Pregnancy Study Groups Consensus Panel (2010) International association of diabetes and pregnancy study groups recommendations on the diagnostic and classification of hyperglycemia in pregnancy. Diabetes Care 33:676–682CrossRefPubMedCentral International Association of Diabetes and Pregnancy Study Groups Consensus Panel (2010) International association of diabetes and pregnancy study groups recommendations on the diagnostic and classification of hyperglycemia in pregnancy. Diabetes Care 33:676–682CrossRefPubMedCentral
11.
Zurück zum Zitat Zhu W-W, Yang H-X, Wei Y-M et al (2013) Evaluation of the value of fasting plasma glucose in first prenatal visit to diagnose gestational diabetes mellitus in China. Diabetes Care 36:586–590CrossRefPubMedPubMedCentral Zhu W-W, Yang H-X, Wei Y-M et al (2013) Evaluation of the value of fasting plasma glucose in first prenatal visit to diagnose gestational diabetes mellitus in China. Diabetes Care 36:586–590CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Jenum AK, Mǿrkrid K, Sletner L et al (2012) Impact of ethnicity on gestational diabetes identified with the WHO and the modified IADPSG criteria: a population-based cohort study. Eur J Endocrinol 166:317–324CrossRefPubMedPubMedCentral Jenum AK, Mǿrkrid K, Sletner L et al (2012) Impact of ethnicity on gestational diabetes identified with the WHO and the modified IADPSG criteria: a population-based cohort study. Eur J Endocrinol 166:317–324CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Cundy T, Ackermann E, Ryan EA (2014) Gestational diabetes: new criteria may triple the prevalence but effect on outcomes is unclear. BMJ 348:g1567CrossRefPubMed Cundy T, Ackermann E, Ryan EA (2014) Gestational diabetes: new criteria may triple the prevalence but effect on outcomes is unclear. BMJ 348:g1567CrossRefPubMed
14.
Zurück zum Zitat Werner EF, Petther CM, Zuckerwise L et al (2012) Screening for gestational diabetes mellitus: are the criteria proposed by the International Association of Diabetes and Pregnancy Study Group cost-effective? Diabetes Care 35:529–535CrossRefPubMedPubMedCentral Werner EF, Petther CM, Zuckerwise L et al (2012) Screening for gestational diabetes mellitus: are the criteria proposed by the International Association of Diabetes and Pregnancy Study Group cost-effective? Diabetes Care 35:529–535CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Mission JF, Ohno MS, Cheng YW, Caughey AB (2012) Gestational diabetes screening with new IADPSG guidelines: a cost-effectiveness analysis. Am J Obstet Gynecol 207:326e1–326e9CrossRef Mission JF, Ohno MS, Cheng YW, Caughey AB (2012) Gestational diabetes screening with new IADPSG guidelines: a cost-effectiveness analysis. Am J Obstet Gynecol 207:326e1–326e9CrossRef
16.
Zurück zum Zitat Gillespie P, Cullinan J, O’Neil C, Dunne F (2013) Modeling the independent effects of gestational diabetes mellitus on maternity care and costs. Diabetes Care 36:1111–1116CrossRefPubMedPubMedCentral Gillespie P, Cullinan J, O’Neil C, Dunne F (2013) Modeling the independent effects of gestational diabetes mellitus on maternity care and costs. Diabetes Care 36:1111–1116CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Committee on Obstetric Practice (2013) Practice bulletin no. 137: gestational diabetes mellitus. Obstet Gynecol 122:406–416CrossRef Committee on Obstetric Practice (2013) Practice bulletin no. 137: gestational diabetes mellitus. Obstet Gynecol 122:406–416CrossRef
18.
Zurück zum Zitat Vandorsten JP, Dodson WC, Espeland MA et al (2013) NIH consensus development conference: diagnosing gestational diabetes mellitus. NIH Consens State Sci Statements 29:1–31PubMed Vandorsten JP, Dodson WC, Espeland MA et al (2013) NIH consensus development conference: diagnosing gestational diabetes mellitus. NIH Consens State Sci Statements 29:1–31PubMed
20.
Zurück zum Zitat Blumer I, Hadar E, Hadden DR et al (2013) Diabetes and pregnancy: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 98:4227–4249CrossRefPubMed Blumer I, Hadar E, Hadden DR et al (2013) Diabetes and pregnancy: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 98:4227–4249CrossRefPubMed
21.
Zurück zum Zitat American Diabetes Association (2014) Standards of medical care in diabetes. Diabetes Care 37:S14–S80CrossRef American Diabetes Association (2014) Standards of medical care in diabetes. Diabetes Care 37:S14–S80CrossRef
22.
Zurück zum Zitat Jiwani A, Marseille E, Lohse N, Damm P, Hod M, Kahn JG (2012) Gestational diabetes mellitus: results from a survey of country prevalence and practices. J Matern Fetal Neonatal Med 25:600–610CrossRefPubMed Jiwani A, Marseille E, Lohse N, Damm P, Hod M, Kahn JG (2012) Gestational diabetes mellitus: results from a survey of country prevalence and practices. J Matern Fetal Neonatal Med 25:600–610CrossRefPubMed
23.
Zurück zum Zitat Buckley BS, Harreiter J, Damm P et al (2012) Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review. Diabet Med 29:844–854CrossRefPubMed Buckley BS, Harreiter J, Damm P et al (2012) Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review. Diabet Med 29:844–854CrossRefPubMed
24.
Zurück zum Zitat Benhalima K, Van Crombrugge P, Devlieger R et al (2013) Screening for pregestational and gestational diabetes in pregnancy: a survey of obstetrical centers in the northern part of Belgium. Diabetol Metab Syndr 5:66CrossRefPubMedPubMedCentral Benhalima K, Van Crombrugge P, Devlieger R et al (2013) Screening for pregestational and gestational diabetes in pregnancy: a survey of obstetrical centers in the northern part of Belgium. Diabetol Metab Syndr 5:66CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Vanderijst J-F, Debieve F, Doucet F et al (2012) Stratégie de dépistage et critères diagnostiques du diabète gestationnel. Propositions du GGOLFB. Rev Med Liege 67(4):179–185, [article in French]PubMed Vanderijst J-F, Debieve F, Doucet F et al (2012) Stratégie de dépistage et critères diagnostiques du diabète gestationnel. Propositions du GGOLFB. Rev Med Liege 67(4):179–185, [article in French]PubMed
31.
Zurück zum Zitat Houshmand A, Møller Jensen D, Mathiesen ER, Damm P (2013) Evolution of diagnostic criteria for gestational diabetes mellitus. Acta Obstet Gynecol Scand 92:739–745CrossRefPubMed Houshmand A, Møller Jensen D, Mathiesen ER, Damm P (2013) Evolution of diagnostic criteria for gestational diabetes mellitus. Acta Obstet Gynecol Scand 92:739–745CrossRefPubMed
32.
Zurück zum Zitat Corcoy R, Lumbreras B, Bartha JL, Ricart W, Grupo Español de Diabetes y Embarazo (2010) New diagnostic criteria for gestational diabetes mellitus after the HAPO study. Are they valid in our environment? Endocrinol Nutr 57:277–280CrossRefPubMed Corcoy R, Lumbreras B, Bartha JL, Ricart W, Grupo Español de Diabetes y Embarazo (2010) New diagnostic criteria for gestational diabetes mellitus after the HAPO study. Are they valid in our environment? Endocrinol Nutr 57:277–280CrossRefPubMed
33.
Zurück zum Zitat Riskin-Mashiah S, Younes G, Dati A, Auslender R (2009) First-trimester fasting hyperglycemia and adverse pregnancy outcomes. Diabetes Care 32:1639–1643CrossRefPubMedPubMedCentral Riskin-Mashiah S, Younes G, Dati A, Auslender R (2009) First-trimester fasting hyperglycemia and adverse pregnancy outcomes. Diabetes Care 32:1639–1643CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat The international Expert Committee (2009) International Expert Committee Report on the role of the A1c assay in the diagnosis of diabetes. Diabetes Care 32:1327–1334CrossRefPubMedCentral The international Expert Committee (2009) International Expert Committee Report on the role of the A1c assay in the diagnosis of diabetes. Diabetes Care 32:1327–1334CrossRefPubMedCentral
35.
Zurück zum Zitat Buhling KJ, Elze L, Henrich W et al (2004) The usefulness of glycosuria and the influence of maternal blood pressure in screening for gestational diabetes. Eur J Obstet Gynecol Reprod Biol 113:145–148CrossRefPubMed Buhling KJ, Elze L, Henrich W et al (2004) The usefulness of glycosuria and the influence of maternal blood pressure in screening for gestational diabetes. Eur J Obstet Gynecol Reprod Biol 113:145–148CrossRefPubMed
36.
Zurück zum Zitat Catalano PM, McIntyre HD, Cruickshank JK et al (2012) The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care 35:780–786CrossRefPubMedPubMedCentral Catalano PM, McIntyre HD, Cruickshank JK et al (2012) The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care 35:780–786CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Ricart W, López J, Mozas J et al (2005) Spanish Group for the Study of the Impact of Carpenter and Coustan GDM Thresholds. Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia. Diabetologia 48:1736–1742CrossRefPubMed Ricart W, López J, Mozas J et al (2005) Spanish Group for the Study of the Impact of Carpenter and Coustan GDM Thresholds. Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia. Diabetologia 48:1736–1742CrossRefPubMed
38.
Zurück zum Zitat Oteng-Ntim E, Varma R, Croker H, Poston L, Doyle P (2012) Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med 10:47CrossRefPubMedPubMedCentral Oteng-Ntim E, Varma R, Croker H, Poston L, Doyle P (2012) Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med 10:47CrossRefPubMedPubMedCentral
39.
40.
Zurück zum Zitat American College of Obstetricians and Gynecologists (2013) ACOG Committee opinion no. 549: obesity in pregnancy. Obstet Gynecol 121:213–217CrossRef American College of Obstetricians and Gynecologists (2013) ACOG Committee opinion no. 549: obesity in pregnancy. Obstet Gynecol 121:213–217CrossRef
41.
Zurück zum Zitat Committee to Reexamine IOM Pregnancy Weight Guidelines, Food and Nutrition Board, Board on Children et al (2009) In: Rasmussen KM, Yaktine AL (eds) Weight gain during pregnancy: reexamining guidelines. The National Academies Press, Washington, DC Committee to Reexamine IOM Pregnancy Weight Guidelines, Food and Nutrition Board, Board on Children et al (2009) In: Rasmussen KM, Yaktine AL (eds) Weight gain during pregnancy: reexamining guidelines. The National Academies Press, Washington, DC
43.
Zurück zum Zitat Waugh N, Pearson D, Royle P (2010) Screening for hyperglycaemia in pregnancy: consensus and controversy. Best Pract Res Clin Endocrinol Metab 24:553–571CrossRefPubMed Waugh N, Pearson D, Royle P (2010) Screening for hyperglycaemia in pregnancy: consensus and controversy. Best Pract Res Clin Endocrinol Metab 24:553–571CrossRefPubMed
44.
Zurück zum Zitat Duran A, Sáenz S, Rorrejón MJ et al (2014) Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St Carlos gestational diabetes study. Diabetes Care 37:2442–2450CrossRefPubMed Duran A, Sáenz S, Rorrejón MJ et al (2014) Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St Carlos gestational diabetes study. Diabetes Care 37:2442–2450CrossRefPubMed
45.
Zurück zum Zitat Agarwal MM, Dhatt GS, Shah SM (2013) Gestational diabetes mellitus: simplifying the international association of diabetes and pregnancy diagnostic algorithm using fasting plasma glucose. Diabetes Care 33:2018–2020CrossRef Agarwal MM, Dhatt GS, Shah SM (2013) Gestational diabetes mellitus: simplifying the international association of diabetes and pregnancy diagnostic algorithm using fasting plasma glucose. Diabetes Care 33:2018–2020CrossRef
46.
Zurück zum Zitat Zhu WW, Fan L, Yang HX et al (2013) Fasting plasma glucose at 24-28 weeks to screen for gestational diabetes mellitus: new evidence from China. Diabetes Care 36:2038–2040CrossRefPubMedPubMedCentral Zhu WW, Fan L, Yang HX et al (2013) Fasting plasma glucose at 24-28 weeks to screen for gestational diabetes mellitus: new evidence from China. Diabetes Care 36:2038–2040CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat Savona-Ventura C, Vassallo J, Marre M, Karamanos B (2012) Hyperglycaemia in pregnancy in Mediterranean women. Acta Diabetol 49:473–480CrossRefPubMed Savona-Ventura C, Vassallo J, Marre M, Karamanos B (2012) Hyperglycaemia in pregnancy in Mediterranean women. Acta Diabetol 49:473–480CrossRefPubMed
48.
Zurück zum Zitat Bellamy L, Casas JP, Hingorani AD, Williams D (2009) Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet 373:1773–1779CrossRefPubMed Bellamy L, Casas JP, Hingorani AD, Williams D (2009) Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet 373:1773–1779CrossRefPubMed
49.
Zurück zum Zitat Reinblatt SL, Morin L, Meltzer SJ (2006) The importance of a postpartum 75 g oral glucose tolerance test in women with gestational diabetes. J Obstet Gynaecol Can 28:690–694CrossRefPubMed Reinblatt SL, Morin L, Meltzer SJ (2006) The importance of a postpartum 75 g oral glucose tolerance test in women with gestational diabetes. J Obstet Gynaecol Can 28:690–694CrossRefPubMed
50.
Zurück zum Zitat Picón MJ, Murri M, Muñoz A, Fernández-García JC, Gomez-Huelgas R, Tinahones FJ (2012) Hemoglobin A1c versus oral glucose tolerance test in postpartum diabetes screening. Diabetes Care 35:1648–1653CrossRefPubMedPubMedCentral Picón MJ, Murri M, Muñoz A, Fernández-García JC, Gomez-Huelgas R, Tinahones FJ (2012) Hemoglobin A1c versus oral glucose tolerance test in postpartum diabetes screening. Diabetes Care 35:1648–1653CrossRefPubMedPubMedCentral
Metadaten
Titel
A proposal for the use of uniform diagnostic criteria for gestational diabetes in Europe: an opinion paper by the European Board & College of Obstetrics and Gynaecology (EBCOG)
verfasst von
Katrien Benhalima
Chantal Mathieu
Peter Damm
André Van Assche
Roland Devlieger
Gernot Desoye
Rosa Corcoy
Tahir Mahmood
Jacky Nizard
Charles Savona-Ventura
Fidelma Dunne
Publikationsdatum
01.07.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Diabetologia / Ausgabe 7/2015
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-015-3615-7

Weitere Artikel der Ausgabe 7/2015

Diabetologia 7/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.