Gestational diabetes: Relevance of diagnostic criteria and preventive strategies for Type 2 diabetes mellitus

Objective: Women with gestational diabetes mellitus (GDM) are at risk to develop Type 2 diabetes mellitus (DM₂). The aim of this study was to compare the effect of three international diagnostic criteria on the prevalence of GDM with its implications for prevention of DM₂ in the population. Materials and methods: One thousand one hundred and seventy-two pregnant women, who underwent the 75-g oral glucose tolerance test for routine, antenatal GDM screening, were classified using the criteria of the American Diabetes Association (ADA), the World Health Organization (WHO) and Australasian Diabetes in Pregnancy Society (ADIPS). The population-attributable risk, (PAR) was used to estimate the proportion of women with DM₂ in the community, who may have been identified much in advance for intervention, by a GDM pregnancy. Results: Using the ADA, WHO and ADPIS criteria, respectively: (a) the prevalence of GDM was 166 (14.2%), 242 (20.6%) and 271 (23.1%) (p < 0.0001); (b) The PAR (95% CI) was 42% (31-52%); 51% (39-62%) and 54% (42-64%). Overall, by all three criteria, 132 (11.3%) women had GDM while 859 (73.3%) were without GDM; the remaining 181 (15.4%) women had classification differences between them. Conclusion: The universal acceptance and the ability of the WHO criteria to detect over half the women with DM₂ earlier during pregnancy, makes it ideally suited to identify women with GDM.