[Screening strategy and diagnostic criteria for gestational diabetes. Proposals of the GGOLFB].
For nearly 50 years, the strategy of screening and the diagnostic criteria for gestational diabetes have been the subject of endless controversies. They differ between countries and from one center to another, mainly because of the lack of hard data allowing to define glycemic thresholds at which a therapeutic management is needed. Recently, a large observational study has demonstrated the existence of a robust relationship between maternal blood sugar and several fetomaternal perinatal complications. This relationship is linear, with no clear threshold that would define gestational diabetes unambiguously. Meanwhile, two randomized intervention trials have shown that the therapeutic management of mild gestational diabetes was associated with improved perinatal outcomes. Based on these data, the "International Association of Diabetes and Pregnancy Study Group" (IADPSG) released new recommendations on screening methods and diagnostic criteria for gestational diabetes. Although already endorsed by several international associations and implemented in some countries, these recommendations still raise questions and criticisms. This is why the "Groupement des Gynécologues Obstétriciens de Langue Française de Belgique" (GGOLFB) organized a meeting between diabetologists and gynecologists which allowed to reach a consensus on the strategy that we intend to implement in our respective centers. The purpose of this paper is to briefly overview the recent advances in gestational diabetes and more particularly to make our key conclusions known to the medical community. This will enable the standardization of the management of gestational diabetes in the French-speaking part of Belgium.
J F
JF
Vanderijst
F
F
Debieve
F
F
Doucet
P
P
Emonts
S
S
Haumont
C
C
Hubinont
C
C
Kirkpatrick
J C
JC
Philips
A
A
Pintiaux
P
P
Rousseau
G
G
Senterre
B
B
Vandeleene
F
F
Féry
D003245:Consensus Statements as Topic; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D008403:Mass Screening; D011247:Pregnancy; D012955:Societies, Medical