title: Clinical impact of women with gestational diabetes mellitus by the new consensus criteria: two year experience in a single institution in Japan.
abstract: There is a paucity of information on perinatal data regarding gestational diabetes mellitus (GDM) by the new criteria from a real experience because the number of health care associations implementing the new criteria is still limited. The aim of this study is to investigate perinatal features of the new criteria-defined GDM. We reviewed a total of 995 women with singleton pregnancy that underwent GDM screening followed by a diagnostic oral glucose tolerance test (OGTT). All women found to have GDM underwent self-monitoring of blood glucose measurements as well as dietary management. Insulin treatment was initiated when dietary treatment did not achieve the glycemic goal. Of the 995 women, 141 had GDM (14.2%): 104 with one, 27 with two, and 10 with three abnormal OGTT values. Women with two or three abnormal OGTT values (2/3-AV) needed insulin treatment more frequently than those with one abnormal OGTT value (1-AV) (70.3% vs 23.1%, P < 0.0001). After adjustment for age, pregravid overweight, gestational weeks at diagnosis, a first-degree family history of diabetes was correlated with the implementation of insulin treatment in women with 1-AV (adjusted odds ratio 3.9; 95% Confidence Interval 1.7-9.2; P = 0.001). When compared perinatal outcomes between women with normal glucose tolerance and GDM, fetal growth and the occurrence of pregnancy-induced hypertension were comparable between the two groups. Our data suggest that the IADPSG-defined GDM with 1-AV show less severe glucose intolerance, but might be at risk of insulin requirement when a first-degree family history of diabetes exists.
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ikenoue
authors.forename: Kei
authors.initials: K
authors.lastname: Miyakoshi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Saisho
authors.forename: Kensuke
authors.initials: K
authors.lastname: Sakai
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kasuga
authors.forename: Marie
authors.initials: M
authors.lastname: Fukutake
authors.forename: Yoko
authors.initials: Y
authors.lastname: Izumi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Minegishi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Yoshimura
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D003927:Diet, Diabetic; D005192:Family Health; D005951:Glucose Tolerance Test; D006785:Hospitals, University; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007390:International Agencies; D007564:Japan; D011248:Pregnancy Complications / Q000209:etiology / Q000517:prevention & control; D011254:Pregnancy in Diabetics / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D003245:Consensus Statements as Topic
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin