title: Diagnosis and potential management of gestational diabetes mellitus using the International association of diabetes and pregnancy study groups criteria.
abstract: OBJECTIVE
  Appropriate screening and plasma glucose control is important during pregnancy, but an international consensus has not been reached regarding the recommended method of screening and diagnosis of gestational diabetes mellitus (GDM). We investigated glucose intolerance in pregnant women diagnosed with GDM, applying stricter screening criteria.
  
  
  METHODS
  The study involved 452 women with singleton pregnancies, who underwent a 2 h 75 g oral glucose tolerance test between January 2006 and December 2010. They had previously been screened for GDM using Japan Society of Obstetrics and Gynecology (JSOG) criteria. We retrospectively re-evaluated their status using International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. The major differences between JSOG and IADPSG criteria are the number of applicable threshold values, and the threshold value for fasting glucose measured by the glucose tolerance test. The insulinogenic index and insulin resistance according to the homeostasis model assessment were compared among groups in the presence or absence of obesity.
  
  
  RESULTS
  GDM was diagnosed in 56 (1.07%) and 133 (2.54%) women based on the JSOG and IADPSG criteria, respectively. Compared to non-GDM, non-obese women, those diagnosed with GDM according to IADPSG criteria had significantly higher insulin resistance, while those diagnosed with GDM exceeding two or more threshold values had significantly lower insulinogenic indexes.
  
  
  CONCLUSIONS
  Adopting stricter diagnostic criteria increased the prevalence of GDM 2.37-fold, as women previously diagnosed with milder abnormalities in glucose levels were then diagnosed as having GDM.
authors.affiliation: Center for Maternal, Fetal, and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Mayumi
authors.identifier: http://orcid.org/0000-0002-9810-358X
authors.initials: M
authors.lastname: Fukatsu
authors.affiliation: Center for Maternal, Fetal, and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takai
authors.affiliation: Center for Maternal, Fetal, and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Matsunaga
authors.affiliation: Center for Maternal, Fetal, and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Sumiko
authors.initials: S
authors.lastname: Era
authors.affiliation: Center for Maternal, Fetal, and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Center for Maternal, Fetal, and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Saito
authors.affiliation: Center for Maternal, Fetal, and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Baba
authors.affiliation: Center for Maternal, Fetal, and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Seki
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017410:Practice Guidelines as Topic / Q000592:standards*; D011247:Pregnancy
keywords: diabetes mellitus; diagnosis; disease management; gestational diabetes