The post-HAPO situation with gestational diabetes: the bright and dark sides
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In 2010, in light of the data coming from the HAPO study, the International Association of Diabetes and Pregnancy Study Groups (IADPSG) proposed a new detection strategy and diagnostic criteria for gestational diabetes based on a one-step approach with a 75 g OGTT. This review analyzes and discusses the bright and dark sides of their application.
The assessment of these recommendations by the international organizations involved in the care of gestational diabetes and a series of observational, retrospective and prospective studies that have been published since 2010 regarding the use of the IADPSG recommendations have been evaluated.
The different international associations involved in the care of pregnancy and of pregnancy complicated by diabetes have not taken an univocal position some of which have accepted them, while others have criticized them. Then, the actual application of the approach recommended by the IADPSG for detecting and diagnosing GDM varies, even at centers that reportedly accept the new diagnostic criteria.
So the challenge lies in making every effort to achieve a global standardization of the strategies for detecting, diagnosing and treating GDM.
KeywordsGestational diabetes Diagnostic criteria Maternal outcome Fetal outcome
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
For this type of study formal consent is not required.
- 1.American Diabetes Association (2006) Diagnosis and classification of diabetes mellitus. Diabetes Care 29(suppl 1):S43–S48Google Scholar
- 3.Metzger BE, Lowe P, Dyer AR et al (2008) Hyperglycemia and adverse pregnancy outcomes. New Engl J Med 38:1991–2002Google Scholar
- 21.Sacks DA, Hadden DR, Deerochanawong C et al (2012) Frequency of gestational diabetes mellitus at collaborating centers based on IADPSG consensus panel-recommended criteria: the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. Diabetes Care 35:526–528CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Duran A, Saenz S, Torrejon MJ et al (2014) Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnancy woman: the St. Carlos Gestational Diabetes Study. Diabetes Care 37:2442–2450CrossRefPubMedGoogle Scholar
- 23.Lapolla A, Dalfrà MG, Ragazzi E et al (2011) New International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommendations for diagnosing gestational diabetes compared with former criteria: a retrospective study on pregnancy outcome. Diabet Med 28(9):1074–1077CrossRefPubMedGoogle Scholar
- 25.Mayo K, Melamed N, Vandenberghe H et al (2105) The impact of adoption of the international association of diabetes in pregnancy study group criteria for the screening and diagnosis of gestational diabetes. Am J Obstet Gynecol 212(2):224–228Google Scholar
- 32.Waters TP, Dyer AR, Scholtens DM et al (2016) Maternal and neonatal morbidity for woman who would be added to the diagnosis of GDM using IADPSG criteria: a secondary analysis of the hyperglycemia and adverse pregnancy outcome study. Diabetes Care 39:2204–2210CrossRefPubMedPubMedCentralGoogle Scholar
- 43.Wang C, Zhu W, Wei Y et al (2016) The predictive effects of early pregnancy lipid profiles and fasting glucose on the risk of gestational diabetes mellitus stratified by body mass index. J Diabetes Res 2016:3013357Google Scholar
- 53.WHO (2013) Diagnostic criteria and classification of hyperglycemia first detected in pregnancy. World Health Organization, GenevaGoogle Scholar
- 54.ACOG (2011) Committee opinion no. 504: screening and diagnosis of gestational diabetes mellitus. Obstet Gynecol 18(3):751–753Google Scholar
- 57.NICE Guidelines (2015) Diabetes in pregnancy: management from preconception to the postnatal period. https://www.nice.org.uk/guidance.ng3