title: Prevalence and risk factors of gestational diabetes in Punjab, North India: results from a population screening program.
abstract: OBJECTIVE
  The World Health Organization (WHO) has in 2013 changed the diagnostic criteria for gestational diabetes mellitus (GDM) to acknowledge the putative effect of mildly elevated fasting plasma glucose (FPG) levels on pregnancy outcomes. We aimed to determine the prevalence and risk factors of GDM comparing the previous WHO 1999 criteria to the WHO 2013 criteria in North India.
  
  
  METHODS
  In a population-based screening programme, 5100 randomly selected North Indian women were studied using a cross-sectional design with a questionnaire, venous FPG and 2-h capillary plasma glucose (PG) after a 75 g oral glucose tolerance test performed between 24 and 28 weeks of pregnancy.
  
  
  RESULTS
  The prevalence of GDM was 35% using WHO 2013 criteria vs 9% using WHO 1999 criteria. FPG measurements identified 94% of WHO 2013 GDM cases as opposed to 11% of WHO 1999 GDM cases. In contrast, 2-h PG measurements identified only 13% of WHO 2013 GDM cases compared with 96% of the WHO 1999 GDM cases. Using logistic regression with backward elimination, urban habitat, illiteracy, non-vegetarianism, increased BMI, Hindu religion and low adult height were all independent risk factors of GDM using the 1999 criteria, whereas only urban habitat, low adult height and increased age were independent risk factors of GDM using the 2013 criteria.
  
  
  CONCLUSIONS
  Intervention studies are needed to justify the WHO 2013 GDM criteria increasing the prevalence four fold to include more than one third of North Indian pregnant women.
authors.affiliation: Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark geeti_arora@hotmail.com.
authors.forename: Geeti P
authors.initials: GP
authors.lastname: Arora
authors.affiliation: Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark.
authors.forename: Richa G
authors.initials: RG
authors.lastname: Thaman
authors.affiliation: Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark.
authors.forename: Rashmi B
authors.initials: RB
authors.lastname: Prasad
authors.affiliation: Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Almgren
authors.affiliation: Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Brøns
authors.affiliation: Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark.
authors.forename: Leif C
authors.initials: LC
authors.lastname: Groop
authors.affiliation: Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark Deep Hospital481-Model Town, Ludhiana, Punjab, IndiaDepartment of Clinical SciencesDiabetes and Endocrinology, Clinical Research Centre, Lund University, Malmö, SwedenDepartment of Endocrinology (Diabetes and Metabolism)Rigshospitalet, Copenhagen, Denmark.
authors.forename: Allan A
authors.initials: AA
authors.lastname: Vaag
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult