title: Screening and diagnosis of diabetes in children and pregnant women.
abstract: The incidence and prevalence of diabetes in children has increased in recent decades. The findings of a nationwide screening program in Taiwan show that type 2 diabetes has replaced type 1 diabetes as the leading cause of diabetes in children and adolescents. Important risk factors for diabetes in children are high or low birth weights, obesity, and a family history of diabetes. The incidence of diabetes reaches plateaus during puberty. Therefore, we have developed a strategy to screen seventh-grade children with diabetes based on urinalysis and a risk score. Gestational diabetes is associated with various adverse perinatal outcomes, particularly macrosomia and birth injury, and a higher rate of Cesarean section. The 100 g oral glucose tolerance test (OGTT) for gestational diabetes was initially designed to predict maternal diabetes after delivery, and was revised by Carpenter and Coustan to predict adverse fetal outcomes. In 2010, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) proposed a 75 g OGTT to define gestational diabetes, resulting in a significant increase in the prevalence of gestational diabetes. Our data suggest that adopting the new IADPSG criteria is reasonable, since they reduce adverse perinatal outcomes and are cost-efficient.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: larsli@ntuh.gov.tw.
authors.forename: Hung-Yuan
authors.initials: HY
authors.lastname: Li
authors.affiliation: Chia Nan University of Pharmacy and Science, Tainan, 717, Taiwan.
authors.forename: Jung-Nan
authors.initials: JN
authors.lastname: Wei
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: En-Tzu
authors.initials: ET
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chien-Nan
authors.initials: CN
authors.lastname: Lee
mesh_terms: D000328:Adult; D002648:Child; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D014943:Global Health; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors
keywords: Children; Diabetes; Diagnosis; Gestational diabetes; Screening