title: Effect of new criteria on the diagnosis of gestational diabetes in women submitted to gastric bypass.
abstract: BACKGROUND
  Bariatric surgery has been shown to improve many obesity related co-morbidities, including gestational diabetes mellitus (GDM). Recently, new diagnostic criteria for GDM following the International Association of Diabetes and Pregnancy Study Group recommendations were implemented. The objective of this study was to compare the use of 2 different GDM criteria in diagnostic and pregnancy outcome after Roux-en-Y gastric bypass (RYGB).
  
  
  METHODS
  Pregnant women who had previously undergone RYGB (n = 30) were screened for GDM with Carpenter and Coustan (C&C) criteria (n = 18) or the new diagnostic criteria (n = 12).
  
  
  RESULTS
  None of the patients screened using C&C criteria where diagnosed with GDM, while 50% of the patients screened with the new criteria had GDM. Among women that underwent oral glucose tolerance tests (OGTT) (n = 19) as required for the new diagnostic criteria, 57.9% developed reactive hypoglycemia. All women diagnosed with GDM had excellent metabolic control during pregnancy and comparing the outcome of these pregnancies and those of women without GDM, there were no significant differences regarding the age at time of surgery or at pregnancy, body mass index before surgery and pregnancy, parity, previous history of GDM, time from surgery to conception, weight lost until pregnancy, weight gain during pregnancy, gestational age at delivery, and birth weight adjusted for gestational age.
  
  
  CONCLUSIONS
  New GDM diagnostic criteria in post-RYGB pregnant women increased the prevalence of GDM diagnostic without changing pregnancy outcomes. In addition, OGTTs were associated with a high rate of reactive hypoglycemia. These data suggest that alternative GDM diagnostic criteria are needed for these postbariatric patients.
authors: Endocrinology Unit, of Hospital São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Portugal.
authors: Cláudia
authors: C
authors: Freitas
authors: Department of Gynecology and Obstetrics, of Hospital São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Portugal.
authors: Célia
authors: C
authors: Araújo
authors: Department of Gynecology and Obstetrics, of Hospital São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Portugal.
authors: Rita
authors: R
authors: Caldas
authors: Department of Nutrition, of Hospital São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Portugal.
authors: Daniela Seabra
authors: DS
authors: Lopes
authors: Department of General Surgery of Hospital São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Portugal.
authors: Mário
authors: M
authors: Nora
authors: Endocrinology Unit, of Hospital São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Portugal; Department of Anatomy, Multidisciplinary Unit for Biomedical Research (UMIB), ICBAS, University of Porto, Portugal. Electronic address: mpmonteiro@icbas.up.pt.
authors: Mariana P
authors: MP
authors: Monteiro
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015331:Cohort Studies; D016208:Databases, Factual; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D015995:Prevalence; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D015431:Weight Loss
chemical_list: D001786:Blood Glucose
keywords: Bariatric surgery; Gestational diabetes mellitus; Obesity; Oral glucose tolerance test; Pregnancy