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Literature Review On Gestational Diabetes

Screening For Gestational Diabetes: A Systematic Review And Meta-analysis

Screening For Gestational Diabetes: A Systematic Review And Meta-analysis

Screening for Gestational Diabetes: A Systematic Review and Meta-Analysis Knowledge and Evaluation Research Unit (G.J.P., J.P.D., V.S., T.E., M.N., L.J.P., V.M.M., M.H.M.), Rochester, Minnesota 55905 Unidad de Conocimiento y Evidencia (G.J.P., J.P.D., V.M.M.), Universidad Peruana Cayetano Heredia, Lima 31, Peru Department of Pediatrics (G.J.P.), Children's Hospital of Michigan, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan 48201 Search for other works by this author on: Knowledge and Evaluation Research Unit (G.J.P., J.P.D., V.S., T.E., M.N., L.J.P., V.M.M., M.H.M.), Rochester, Minnesota 55905 Unidad de Conocimiento y Evidencia (G.J.P., J.P.D., V.M.M.), Universidad Peruana Cayetano Heredia, Lima 31, Peru and Department of Internal Medicine (J.P.D.), Henry Ford Hospital, Detroit, Michigan 48202 Search for other works by this author on: Knowledge and Evaluation Research Unit (G.J.P., J.P.D., V.S., T.E., M.N., L.J.P., V.M.M., M.H.M.), Rochester, Minnesota 55905 Division of Endocrinology and Metabolism (V.S.), Louisiana State University Health Sciences Center, Shreveport, Louisiana 70112 Search for other works by this author on: Knowledge and Evaluation Research Unit (G.J.P., J.P.D., V.S., T.E., M.N., L.J.P., V.M.M., M.H.M.), Rochester, Minnesota 55905 Search for other works by this author on: Knowledge and Evaluation Research Unit (G.J.P., J.P.D., V.S., T.E., M.N., L.J.P., V.M.M., M.H.M.), Rochester, Minnesota 55905 Search for other works by this author on: Knowledge and Evaluation Research Unit (G.J.P., J.P.D., V.S., T.E., M.N., L.J.P., V.M.M., M.H.M.), Rochester, Minnesota 55905 Search for other works by this author on: Divisions of Endocrinology, Diabetes, Metabolism, and Nutrition (A.V., V.M.M.), Rochester, Minnesota 55905 Search Continue reading >>

Quality Of Life In Women With Gestational Diabetes Mellitus: A Systematic Review

Quality Of Life In Women With Gestational Diabetes Mellitus: A Systematic Review

Copyright © 2017 Daniela Marchetti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background and Objective. Diagnosis of Gestational Diabetes Mellitus (GDM) could significantly increase the likelihood of health problems concerning both potential risks for the mother, fetus, and child’s development and negative effects on maternal mental health above all in terms of a diminished Quality of Life (QoL). The current systematic review study is aimed at further contributing to an advancement of knowledge about the clinical link between GDM and QoL. Methods. According to PRISMA guidelines, PubMed, Web of Science, Scopus, and Cochrane databases were searched for studies aimed at evaluating and/or improving levels of QoL in women diagnosed with GDM. Results. Fifteen research studies were identified and qualitatively analyzed by summarizing results according to the following two topics: GDM and QoL and interventions on QoL in patients with GDM. Studies showed that, in women with GDM, QoL is significantly worse in both the short term and long term. However, improvements on QoL can be achieved through different intervention programs by enhancing positive diabetes-related self-management behaviors. Conclusion. Future studies are strongly recommended to further examine the impact of integrative programs, including telemedicine and educational interventions, on QoL of GDM patients by promoting their illness acceptance and healthy lifestyle behaviors. 1. Introduction Gestational Diabetes Mellitus (GDM) is defined as “diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt d Continue reading >>

Non Classical Risk Factors For Gestational Diabetes Mellitus: A Systematic Review Of The Literature

Non Classical Risk Factors For Gestational Diabetes Mellitus: A Systematic Review Of The Literature

Age, obesity and family history of diabetes are well known risk factors for gestational diabetes mellitus. Others are more controversial. The objective of this review is to find evidence in the literature that justifies the inclusion of these other conditions among risk factors. The MEDLINE, Cochrane, LILACS and Pan American Health Organization databases were searched, covering articles dating from between 1992 and 2006. Keywords were used in combination (AND) with gestational diabetes mellitus separately and with each one of the risk factors studied. The methodological quality of the studies included was assessed, resulting in the selection of 41 papers. Most studies investigating maternal history of low birth weight, low stature, and low level of physical activity have found positive associations with gestational diabetes mellitus. Low socioeconomic levels, smoking during pregnancy, high parity, belonging to minority groups, and excessive weight gain during pregnancy presented conflicting results. Publication bias cannot be ruled out. Standardization of techniques, cutoff points for screening and diagnosis, as well as studies involving larger sample sizes would allow future meta-analyses. Gestational Diabetes; Diabetes Mellitus; Risk Factors Idade, obesidade e histria familiar de diabetes so fatores de risco bem conhecidos para diabetes mellitus gestacional. Outros so controversos. O objetivo desta reviso encontrar evidncias na literatura que justifiquem a incluso dessas condies entre os fatores de risco. Bases de dados MEDLINE, Cochrane, LILACS e Organizao Pan-Americana da Sade foram procuradas. A reviso incluiu artigos de 1992 a 2006. Palavras-chave foram usadas em combinao com diabetes mellitus gestacional separadamente e com cada um dos fatores de risco estudados Continue reading >>

Gestational Diabetes Mellitus And Macrosomia: A Literature Review

Gestational Diabetes Mellitus And Macrosomia: A Literature Review

Abstract Background: Fetal macrosomia, defined as a birth weight ≥4,000 g, may affect 12% of newborns of normal women and 15-45% of newborns of women with gestational diabetes mellitus (GDM). The increased risk of macrosomia in GDM is mainly due to the increased insulin resistance of the mother. In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called ‘large for gestational age'. This paper reviews studies that explored the impact of GDM and fetal macrosomia as well as macrosomia-related complications on birth outcomes and offers an evaluation of maternal and fetal health. Summary: Fetal macrosomia is a common adverse infant outcome of GDM if unrecognized and untreated in time. For the infant, macrosomia increases the risk of shoulder dystocia, clavicle fractures and brachial plexus injury and increases the rate of admissions to the neonatal intensive care unit. For the mother, the risks associated with macrosomia are cesarean delivery, postpartum hemorrhage and vaginal lacerations. Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age (during adolescence) and are more likely to develop type II diabetes later in life. Besides, the findings of several studies that epigenetic alterations of different genes of the fetus of a GDM mother in utero could result in the transgenerational transmission of GDM and type II diabetes are of concern. © 2015 S. Karger AG, Basel Key Messages • Fetal macrosomia, resulting from fetal hyperinsulinemia in response to maternal diabetes, might be a predictor of later glucose intolerance. • Maternal diabetes during pregnancy can lead to a transgenerati Continue reading >>

Gestational Diabetes And Pregnancy Outcomes - A Systematic Review Of The World Health Organization (who) And The International Association Of Diabetes In Pregnancy Study Groups (iadpsg) Diagnostic Criteria

Gestational Diabetes And Pregnancy Outcomes - A Systematic Review Of The World Health Organization (who) And The International Association Of Diabetes In Pregnancy Study Groups (iadpsg) Diagnostic Criteria

Wendland et al; licensee BioMed Central Ltd.2012 Two criteria based on a 2 h 75 g OGTT are being used for the diagnosis of gestational diabetes (GDM), those recommended over the years by the World Health Organization (WHO), and those recently recommended by the International Association for Diabetes in Pregnancy Study Group (IADPSG), the latter generated in the HAPO study and based on pregnancy outcomes. Our aim is to systematically review the evidence for the associations between GDM (according to these criteria) and adverse outcomes. We searched relevant studies in MEDLINE, EMBASE, LILACS, the Cochrane Library, CINHAL, WHO-Afro library, IMSEAR, EMCAT, IMEMR and WPRIM. We included cohort studies permitting the evaluation of GDM diagnosed by WHO and or IADPSG criteria against adverse maternal and perinatal outcomes in untreated women. Only studies with universal application of a 75 g OGTT were included. Relative risks (RRs) and their 95% confidence intervals (CI) were obtained for each study. We combined study results using a random-effects model. Inconsistency across studies was defined by an inconsistency index (I2) > 50%. Data were extracted from eight studies, totaling 44,829 women. Greater risk of adverse outcomes was observed for both diagnostic criteria. When using the WHO criteria, consistent associations were seen for macrosomia (RR = 1.81; 95%CI 1.47-2.22; p < 0.001); large for gestational age (RR = 1.53; 95%CI 1.39-1.69; p < 0.001); perinatal mortality (RR = 1.55; 95% CI 0.88-2.73; p = 0.13); preeclampsia (RR = 1.69; 95%CI 1.31-2.18; p < 0.001); and cesarean delivery (RR = 1.37;95%CI 1.24-1.51; p < 0.001). Less data were available for the IADPSG criteria, and associations were inconsistent across studies (I2 73%). Magnitudes of RRs and their 95%CIs were 1.73 Continue reading >>

Gestational Diabetes: A Review Of The Current Literature And Guidelines.

Gestational Diabetes: A Review Of The Current Literature And Guidelines.

Gestational diabetes: a review of the current literature and guidelines. Department of Obstetrics and Gynecology, AZ Middelheim, Antwerpen, Belgium. [email protected] Obstet Gynecol Surv. 2007 Feb;62(2):125-36. Despite large numbers of original research studies spanning 4 decades there is still no consensus on the subject of gestational diabetes. Should all pregnant women be screened or only those with risk factors? Or is it safe not to screen at all? Which screening test and which diagnostic test are the most reliable? Which cutoff values should we use? What are the risks involved for mother and baby and can treatment improve outcome? What is the connection between gestational diabetes and diabetes mellitus type II? Are there disadvantages to screening? A review of relevant articles shows that definitive answers to these questions are not yet available. There is no gold standard screening test and no threshold glucose value above which complications are markedly increased. On the contrary, there appears to be a continuum of slowly increasing risks with rising blood glucose values, where it seems difficult to draw a clear line between pathology and physiology. Moreover, treatment has thus far not been shown to significantly improve outcome. There seems to be an indistinct area between the diagnosis of gestational diabetes and diabetes mellitus type II, where women with risk factors for one are also predisposed to develop the other, thereby confusing the diagnosis. Finally, the disadvantages to diagnosing and treating women without a clearly proven benefit seem to be significant. Therefore it seems defensible to suspend all screening and treatment for gestational diabetes, or at least significantly raise the threshold for making a positive diagnosis and init Continue reading >>

Gestational Diabetes: A Review Of The Current Literature And Guidelines

Gestational Diabetes: A Review Of The Current Literature And Guidelines

Unlabelled: Despite large numbers of original research studies spanning 4 decades there is still no consensus on the subject of gestational diabetes. Should all pregnant women be screened or only those with risk factors? Or is it safe not to screen at all? Which screening test and which diagnostic test are the most reliable? Which cutoff values should we use? What are the risks involved for mother and baby and can treatment improve outcome? What is the connection between gestational diabetes and diabetes mellitus type II? Are there disadvantages to screening? A review of relevant articles shows that definitive answers to these questions are not yet available. There is no gold standard screening test and no threshold glucose value above which complications are markedly increased. On the contrary, there appears to be a continuum of slowly increasing risks with rising blood glucose values, where it seems difficult to draw a clear line between pathology and physiology. Moreover, treatment has thus far not been shown to significantly improve outcome. There seems to be an indistinct area between the diagnosis of gestational diabetes and diabetes mellitus type II, where women with risk factors for one are also predisposed to develop the other, thereby confusing the diagnosis. Finally, the disadvantages to diagnosing and treating women without a clearly proven benefit seem to be significant. Therefore it seems defensible to suspend all screening and treatment for gestational diabetes, or at least significantly raise the threshold for making a positive diagnosis and initiating treatment, until further research has proven a clear benefit.Target audience: Obstetricians & Gynecologists, Family Physicians.Learning objectives: After completion of this article, the reader should be a Continue reading >>

Sade Pblica - Non Classical Risk Factors For Gestational Diabetes Mellitus: A Systematic Review Of The Literature Non Classical Risk Factors For Gestational Diabetes Mellitus: A Systematic Review Of The Literature

Sade Pblica - Non Classical Risk Factors For Gestational Diabetes Mellitus: A Systematic Review Of The Literature Non Classical Risk Factors For Gestational Diabetes Mellitus: A Systematic Review Of The Literature

Non classical risk factors for gestational diabetes mellitus: a systematic review of the literature Fatores de risco no clssicos para diabetes mellitus gestacional: uma reviso sistemtica da literatura Maria Alice Souza de Oliveira Dode; In S. dos Santos Programa de Ps-graduao em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil Age, obesity and family history of diabetes are well known risk factors for gestational diabetes mellitus. Others are more controversial. The objective of this review is to find evidence in the literature that justifies the inclusion of these other conditions among risk factors. The MEDLINE, Cochrane, LILACS and Pan American Health Organization databases were searched, covering articles dating from between 1992 and 2006. Keywords were used in combination (AND) with gestational diabetes mellitus separately and with each one of the risk factors studied. The methodological quality of the studies included was assessed, resulting in the selection of 41 papers. Most studies investigating maternal history of low birth weight, low stature, and low level of physical activity have found positive associations with gestational diabetes mellitus. Low socioeconomic levels, smoking during pregnancy, high parity, belonging to minority groups, and excessive weight gain during pregnancy presented conflicting results. Publication bias cannot be ruled out. Standardization of techniques, cutoff points for screening and diagnosis, as well as studies involving larger sample sizes would allow future meta-analyses. Gestational Diabetes; Diabetes Mellitus; Risk Factors Idade, obesidade e histria familiar de diabetes so fatores de risco bem conhecidos para diabetes mellitus gestacional. Outros so controversos. O objetivo desta reviso encontrar evidncias na l Continue reading >>

Effects Of Treatment In Women With Gestational Diabetes Mellitus: Systematic Review And Meta-analysis

Effects Of Treatment In Women With Gestational Diabetes Mellitus: Systematic Review And Meta-analysis

Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis BMJ 2010; 340 doi: (Published 01 April 2010) Cite this as: BMJ 2010;340:c1395 Karl Horvath, project manager EBM review center 1 , head of outpatient facility diabetes and metabolism 2 , Ralf Bender, head of department of medical biometry 3 , Hilda Bastian, head of department of health information 3 , Andrea Siebenhofer, professor for chronic care and health services research 4 , project manager 1 1EBM Review Center, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria 2Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15 3Institute for Quality and Efficiency in Health Care (IQWiG), Dillenburger Str. 27, 51105 Cologne, Germany 4Institute of General Practice, Goethe University, Frankfurt, Germany Correspondence to: K Horvath Karl.Horvath{at}medunigraz.at Objective To summarise the benefits and harms of treatments for women with gestational diabetes mellitus. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Embase, Medline, AMED, BIOSIS, CCMed, CDMS, CDSR, CENTRAL, CINAHL, DARE, HTA, NHS EED, Heclinet, SciSearch, several publishers databases, and reference lists of relevant secondary literature up to October 2009. Review methods Included studies were randomised controlled trials of specific treatment for gestational diabetes compared with usual care or intensified compared with less intensified specific treatment. Results Five randomised controlled trials matched the inclusion criteria for specific versus usual treatment. All studies used a tw Continue reading >>

Gestational Diabetes Mellitus In Africa: A Systematic Review

Gestational Diabetes Mellitus In Africa: A Systematic Review

Gestational Diabetes Mellitus in Africa: A Systematic Review Affiliation Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa Affiliations Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa, Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom Affiliations Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa, Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom Gestational Diabetes Mellitus in Africa: A Systematic Review Gestational diabetes mellitus (GDM) is any degree of impaired glucose tolerance first recognised during pregnancy. Most women with GDM revert to normal glucose metabolism after delivery of their babies; however, they are at risk of developing type 2 diabetes later in life as are their offspring. Determining a countrys GDM prevalence can assist with policy guidelines regarding GDM screening and management, and can highlight areas requiring research. This systematic review assesses GDM prevalence in Africa. Three electronic databases were searched without language restrictions; PubMed, Scopus and the Cochrane Library. Thirty-one search terms were searched. Eligible articles defined GDM, stated what GDM screening approaches were employed and reported GDM prevalence. The reporting quality and risk of bias within each study was assessed. The PRISMA guidelines for systematic reviews were followed. The literature search identified 466 unique records. Sixty full text articles Continue reading >>

Resistin Concentration And Gestational Diabetes: A Systematic Review Of The Literature

Resistin Concentration And Gestational Diabetes: A Systematic Review Of The Literature

Volume 97, Issue 1 , March 2013, Pages 120-127 Resistin concentration and gestational diabetes: a systematic review of the literature Get rights and content Gestational diabetes (GD) exposes mothers and infants to the risk of immediate and later adverse outcomes. Increased insulin resistance is a common feature of GD and obesity. Because of its critical role in regulating insulin sensitivity, resistin has been implicated in the physiopathology of GD. The aim of this study was to review the existing literature on the relationship between circulating maternal resistin levels and GD. Three electronic databases (MEDLINE, EMBASE, and LILACS) were searched for pertinent studies published from 2001 to 2012, without language restrictions. Eleven studies, with a total of 639 participants between 23 and 41 weeks of gestation, were included. The number of GD patients per study ranged from 11 to 81, with varying degrees of disease severity and several different GD diagnostic criteria. Mean concentrations of resistin varied widely both in control women (0.0522.21ng/ml) and in GD patients (0.0562.38ng/ml). We performed a meta-analysis including a total of 10 studies, and also subgroup analyses according to gestational age at sample collection (up to 32 and >33 weeks). The pooled absolute mean difference (WMD) in resistin levels was slightly lower in GD patients than in controls, but this did not reach statistical significance (WMD=0.02, 95% CI 0.07 to 0.04). According to the data from the 11 studies analyzed, there was no association between circulating resistin levels and GD. However, this result should be interpreted with caution owing to the large heterogeneity amongst the existing published studies. Continue reading >>

Mechanisms In Endocrinology: Epigenetic Modifications And Gestational Diabetes: A Systematic Review Of Published Literature

Mechanisms In Endocrinology: Epigenetic Modifications And Gestational Diabetes: A Systematic Review Of Published Literature

MECHANISMS IN ENDOCRINOLOGY: Epigenetic modifications and gestational diabetes: a systematic review of published literature 1Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway 2Faculty of Medicine, University of Oslo, Institute of Clinical Medicine, Oslo, Norway 3Department of Clinical Sciences, Diabetes and Endocrinology CRC, Lund University Diabetes Centre, Malm, Sweden 4Department of Pediatric and Adolescents Medicine, Akershus University Hospital, Lrenskog, Norway 5MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK 6Finnish Institute of Molecular Medicine (FIMM), Helsinki University, Helsinki, Finland 7Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway Correspondence should be addressed to G-H Moen; Email: g.h.o.moen{at}studmed.uio.no Objective To summarize the current knowledge on epigenetic alterations in mother and offspring subjected to gestational diabetes (GDM) and indicate future topics for research. Methods We performed extensive searches in PubMed, EMBASE and Google scholar, using a combination of the search terms: GDM, gestational diabetes, epigenetic(s), methylation, histone modification, histone methylation, histone acetylation, microRNA and miRNA. Studies that compared women diagnosed with GDM and healthy controls were included. Two authors independently scanned the abstracts, and all included papers were read by at least two authors. The searches were completed on October 31st, 2016. Results We identified 236 articles, of which 43 were considered relevant for this systematic review. Studies published showed that epigenetic alterations could be found in both mothers with GDM and their offspring. However, differenc Continue reading >>

Effect Of Treatment Of Gestational Diabetes Mellitus: A Systematic Review And Meta-analysis

Effect Of Treatment Of Gestational Diabetes Mellitus: A Systematic Review And Meta-analysis

Effect of Treatment of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis Affiliation Department of Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon-Pathom, Thailand Affiliation Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand Affiliation Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand Effect of Treatment of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis To assess the efficacy and safety of treating pregnant women with gestational diabetes mellitus in comparison to usual antenatal care. A systematic review and meta-analysis was conducted by including randomized controlled trials comparing any form of therapeutic intervention in comparison to usual antenatal care. A literature search was conducted using electronic databases together with a hand search of relevant journals and conference proceedings. Ten studies involving 3,881 patients contributed to meta-analysis. Our results indicated that gestational diabetes mellitus treatment significantly reduced the risk for macrosomia (RR, 0.47; 95% CI, 0.380.57), large for gestational age births (RR, 0.55; 95% CI, 0.450.67), shoulder dystocia (RR, 0.42; 95% CI, 0.230.77) and gestational hypertension (RR, 0.68; 95% CI, 0.530.87) without causing any significant increase in the risk for small for gestational age babies. However, no significant difference was observed between the two groups regarding perinatal/neonatal mortality, neonatal hypoglycemia, birth trauma, preterm births, pre-eclampsia, caesarean section and labor induction. Treating GDM reduces risk for many important adverse pregnancy outcomes and its association with any harm seems unlikely. Citation: Poolsup N, Suksomboon N, Amin M (2014) Effect of T Continue reading >>

Screening Tests For Gestational Diabetes: A Systematic Review For The U.s. Preventive Services Task Force Free

Screening Tests For Gestational Diabetes: A Systematic Review For The U.s. Preventive Services Task Force Free

Abstract Background: A 50-g oral glucose challenge test (OGCT) is a widely accepted screening method for gestational diabetes mellitus (GDM), but other options are being considered. Purpose: To systematically review the test characteristics of various screening methods for GDM across a range of recommended diagnostic glucose thresholds. Data Sources: 15 electronic databases from 1995 to May 2012, reference lists, Web sites of relevant organizations, and gray literature. Study Selection: Two reviewers independently identified English-language prospective studies that compared any screening test for GDM with any reference standard. Data Extraction: One reviewer extracted and a second reviewer verified data from 51 cohort studies. Two reviewers independently assessed methodological quality. Data Synthesis: The sensitivity, specificity, and positive and negative likelihood ratios for the OGCT at a threshold of 7.8 mmol/L (140 mg/dL) were 70% to 88%, 69% to 89%, 2.6 to 6.5, and 0.16 to 0.33, respectively. At a threshold of 7.2 mmol/L (130 mg/dL), the test characteristics were 88% to 99%, 66% to 77%, 2.7 to 4.2, and 0.02 to 0.14, respectively. For a fasting plasma glucose threshold of 4.7 mmol/L (85 mg/dL), they were 87%, 52%, 1.8, and 0.25, respectively. Glycated hemoglobin level had poorer test characteristics than fasting plasma glucose level or the OGCT. No studies compared the OGCT with International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Limitations: The lack of a gold standard for confirming GDM limits comparisons. Few data exist for screening tests before 24 weeks’ gestation. Conclusion: A 50-g oral glucose challenge test (OGCT) is the most widely accepted screening method for gestational diabetes mellitus (GDM) in North Continue reading >>

Screening For Gestational Diabetes : A Systematic Review And Economic Evaluation - Wrap: Warwick Research Archive Portal

Screening For Gestational Diabetes : A Systematic Review And Economic Evaluation - Wrap: Warwick Research Archive Portal

Screening for gestational diabetes : a systematic review and economic evaluation Scott, David A., Loveman, E., McIntyre, Linda and Waugh, Norman (2002)Screening for gestational diabetes : a systematic review and economic evaluation. Health Technology Assessment, Vol.6 (No.11). Screening for gestational diabetes mellitus (GDM) has been controversial, with some expert bodies advising universal screening, others selective screening, and yet others advising against screening at all. This has partly been a result of debate about the definition of GDM, and partly because of the profusion of different tests available, both for screening and definite diagnosis. In the UK, there is no national policy on screening, and a variety of practices exist in different parts of the country. There have also been doubts about the treatment of GDM, and particularly about management of minor degrees of glucose elevation, which are better described as glucose intolerance rather than true diabetes. To provide an updated review of current knowledge, to clarify research needs, and to assist with policy making in the interim, pending future research. A literature review was carried out, with a particular focus on screening methods and costs, and an appraisal of screening for GDM against the criteria for assessing screening programmes used by the UK National Screening Committee (NSC). There is still debate about what is meant by GDM the threshold for diagnosis is not soundly based; the terms GDM and impaired glucose tolerance are not used in a standard fashion in pregnancy; there is almost certainly a continuum of risk to the baby, rather than there being separate normal and abnormal groups; and the key risk factor in most women may be maternal overweight, with glucose intolerance being an associa Continue reading >>

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