Screening for gestational diabetes mellitus: cost-utility of different screening strategies based on a woman's individual risk of disease Screening for gestational diabetes mellitus: cost-utility of different screening strategies based on a woman's individual risk of disease Screening for gestational diabetes mellitus: cost-utility of different screening strategies based on a woman's individual risk of disease Round JA, Jacklin P, Fraser RB, Hughes RG, Mugglestone MA, Holt RI Record Status (...) This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The objective was to assess the cost-effectiveness of eight screening strategies for gestational diabetes. The authors concluded that some form of screening was usually cost-effective, but the best strategy varied

Accuracy of the random glucose test as screening test for gestational diabetes mellitus: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

Metformin should be considered in the treatment of gestational diabetes: a prospective randomised study To examine if oral metformin is as effective as insulin in the prevention of fetal macrosomy in pregnancies complicated with gestational diabetes mellitus (GDM).Open-label prospective randomised controlled study.Maternity outpatient clinics in a secondary and tertiary level hospital in Finland.One hundred women with GDM who did not attain euglycaemia with diet.Women were randomised to therapy (...) with insulin (n = 50) or oral metformin (n = 50).Incidence of large-for-gestational-age (LGA) infants and neonatal morbidity.There were no statistically significant differences in the incidence of LGA (8.5 versus 10.0%, P = 0.97), mean birthweight, mean cord artery pH or neonatal morbidity between the insulin and metformin groups. Fifteen (31.9%) of the 47 women randomised to metformin needed supplemental insulin. They were more obese (with a body mass index of 36 versus 30 kg/m(2), P = 0.002), had higher

Gestational Diabetes - Whom Do We Treat?

Diagnosis and Treatment of Gestational Diabetes Diagnosis and Treatment of Gestational Diabetes Scientific Impact Paper No. 23 January 2011Diagnosis and Treatment of Gestational Diabetes 1. Background Historically, there has been controversy over screening and diagnosis of gestational diabetes. The 2002 National Institute for Health and Clinical Excellence (NICE) Health Technology Assessment concluded that there was insufficient evidence to advocate universal screening in pregnancy while noting (...) women. The results of this large observational study formed the basis of a reconsideration of diagnosis and screening for diabetes in a consensus report published in 2010 4 under the auspices of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). A further major trial examining the effect on pregnancy outcomes of management of gestational diabetes was reported in 2009, 5 while a randomised controlled trial in 2008 examined the efficacy of metformin, 6 adding to the older

Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes mellitus Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes mellitus Development of a model to assess the cost-effectiveness of gestational diabetes mellitus screening and lifestyle change for the prevention of type 2 diabetes (...) mellitus Lohse N, Marseille E, Kahn JG Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The study examined the cost-effectiveness of gestational diabetes mellitus screening and management using a mathematical model (GDModel). The authors

Resistance exercise and glycemic control in women with gestational diabetes mellitus The objective of the study was to evaluate the effect of a resistance exercise program with an elastic band on insulin requirement and glycemic control in patients with gestational diabetes mellitus (GDM).Sixty-four patients with gestational diabetes mellitus were randomly assigned into 2 groups: an exercise group (EG; n = 32) and a control group not submitted to the exercise program (CG; n = 32).A significant

Gestational diabetes mellitus: simplifying the international association of diabetes and pregnancy diagnostic algorithm using fasting plasma glucose To determine the impact of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria on 1) gestational diabetes mellitus (GDM) diagnosis compared with the American Diabetes Association (ADA) criteria and 2) the fasting plasma glucose (FPG) to predict GDM.In 10,283 pregnant women undergoing a 75-g oral glucose tolerance

Oral anti-diabetic agents for women with pre-existing diabetes mellitus/impaired glucose tolerance or previous gestational diabetes mellitus. While most guidelines recommend the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral agents have obvious benefits for patient acceptability and adherence. It is necessary, however, to assess the effects of these anti-diabetic agents on maternal and infant health outcomes. Additionally, women with previous gestational (...) diabetes mellitus are increasingly found to be predisposed to impaired glucose tolerance and, despite the potential need for intervention for these women, there has been little evidence about the use of oral anti-diabetic agents by these women pre-conceptionally or during a subsequent pregnancy.To investigate the effect of oral anti-diabetic agents in women with pre-existing diabetes mellitus, impaired glucose tolerance or previous gestational diabetes planning a pregnancy or pregnant women

First-trimester follistatin-like-3 levels in pregnancies complicated by subsequent gestational diabetes mellitus OBJECTIVE To determine whether maternal levels of follistatin-like-3 (FSTL3), an inhibitor of activin and myostatin involved in glucose homeostasis, are altered in the first trimester of pregnancies complicated by subsequent gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS This was a nested case-control study of subjects enrolled in a prospective cohort of pregnant (...) women with and without GDM (> or =2 abnormal values on a 100-g glucose tolerance test at approximately 28 weeks of gestation). We measured FSTL3 levels in serum collected during the first trimester of pregnancy. Logistic regression analyses were used to determine the risk of GDM. RESULTS Women who developed GDM (n = 37) had lower first-trimester serum levels of FSTL3 compared with women who did not (n = 127) (median 10,789 [interquartile range 7,013-18,939] vs. 30,670 [18,370-55,484] pg/ml, P

Gestational diabetes mellitus (GDM). Evidence-based nutrition practice guideline. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding

Risk factors for gestational diabetes mellitus in Chinese women: a prospective study of 16,286 pregnant women in China To determine the incidence of gestational diabetes mellitus (GDM) in China and to further identify population specific risk factors for GDM.Following a universal GDM screening recommendation, 16,286 pregnant women who underwent a 50-g glucose challenge test from 18 cities in China were followed up through pregnancy. GDM was confirmed by oral glucose tolerance test according (...) to American Diabetes Association criteria.The incidence of GDM was 4.3%. Previously reported risk factors for GDM, including advanced maternal age, pre-pregnancy obesity and family history of diabetes, were strongly associated with an elevated GDM risk. Moreover, after the adjustment for the above-mentioned risk factors, a history of recurrent vulvovaginal candidiasis, residency in south China and a history of spontaneous abortion were significantly associated with an increased GDM risk; adjusted odds

of cesarean delivery, major perineal trauma, low 5-min APGAR score, and neonatal ICU admission) for four risk-defined groups (low-risk, advanced maternal age, hypertension, and any type of diabetes mellitus) found that for the DM group optimal time of delivery was 40 weeks 3 days to 41 weeks 1 day. 46 S A 1993 randomized trial found that in women with uncomplicated insulin-requiring gestational or class B pregestational diabetes, expectant management of pregnancy after 38 weeks' gestation did not reduce (...) What is known about options and approaches to intrapartum management of women with gestational diabetes mellitus (GDM)? KTA Evidence Summary: Intrapartum Management of Patients with Gestational Diabetes Mellitus (GDM) Page 1 of 19 May 2010 May 2010 – Knowledge to Action Evidence Summary What is known about options and approaches to fetal surveillance and intrapartum management of women with gestational diabetes mellitus (GDM)? This report aims to summarize the evidence around the intrapartum

, Wilson LM, Bass EB, Nicholson WK. Risk Factors for Type 2 Diabetes Among Women with Gestational Diabetes: A Systematic Review. Am J Med 2009; 122: 207-214. 17 Nicholson WK, Wilson LM, Witkop CT, Baptiste-Roberts K, Bennett WL, Bolen S, Barone BB, Golden SH, Gary TL, Neale DM, Bass EB. Therapeutic Management, Delivery, and Postpartum Risk Assessment and Screening in Gestational Diabetes. Evidence Report/Technology Assessment No. 162 (Prepared by the Johns Hopkins KTA Evidence Summary: Postpartum (...) Post Partum Care for Gestational Diabetes Mellitus KTA Evidence Summary: Postpartum Intervention for Women with History of GDM Page 1 of 19 March 2010 March 2010 – Knowledge to Action Evidence Summary What is known about postpartum intervention for women with history of GDM? Gestational diabetes mellitus (GDM) is a sentinel event in the life of a woman of reproductive age that confers risk to both mother and baby for future development of type 2 diabetes mellitus (T2D) and a host of other

[Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestational diabetes: efficacy and safety] Sistemes de monitoratge continu de glucosa de Medtronic-Minimed a pacients amb diabetis mellitus de tipus 1 i gestacional: eficacia i seguretat [Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestational diabetes: efficacy and safety] Sistemes de monitoratge continu de glucosa de Medtronic-Minimed (...) a pacients amb diabetis mellitus de tipus 1 i gestacional: eficacia i seguretat [Medtronic-Minimed Continuous Glucose Monitoring System for patients with type 1 diabetes mellitus and gestational diabetes: efficacy and safety] Solans M, Kotzeva A, Almazan C Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Solans M, Kotzeva A, Almazan C. Sistemes de

Gestational diabetes: fasting capillary glucose as a screening test in a multi-ethnic, high-risk population In populations at high risk of gestational diabetes mellitus (GDM), screening every pregnant woman by an oral glucose tolerance test (OGTT) is very demanding. The aim of this study was to determine the value of the fasting capillary glucose (FCG) as a screening test for GDM.FCG was measured by a plasma-correlated glucometer in 1465 pregnant women who underwent a one-step diagnostic 75-g (...) OGTT for universal screening of GDM.One hundred and ninety-six (13.4%) women had GDM as defined by the criteria of the American Diabetes Association. The area under the receiver operating characteristic curve (AUC) of the FCG was 0.83 (95% confidence interval 0.80-0.86). A FCG threshold of 4.7 mmol/l (at an acceptable sensitivity of 86.0%) independently could rule-out GDM in 731 (49.9%) women, while the FCG could rule-in GDM (100% specificity) in 16 (1.1%) additional women; therefore, approximately

Adolescent manifestations of metabolic syndrome among children born to women with gestational diabetes in a general-population birth cohort The association between maternal gestational diabetes (GDM) and manifestations of metabolic syndrome among Caucasian adolescents was studied with data from the population-based Northern Finland 1986 Birth Cohort. This is a longitudinal cohort study from early pregnancy until offspring age 16 years and includes data from a risk group-based GDM screen (...) %, 7.5%), and fasting insulin (10.20 vs. 9.30 milliunits/L, 95% CI: 5.9%, 26.0%) were higher, and homeostatic model assessment-insulin sensitivity (74.7 vs. 82.3, 95% CI: -20.6%, -5.4%) was lower in the OGDM group. These differences were similar after an additional adjustment for birth weight and gestational age. The differences in waist circumference, insulin, and homeostatic model assessment-insulin sensitivity were attenuated but remained statistically significant after additional adjustment

Iron supplement in pregnancy and development of gestational diabetes--a randomised placebo-controlled trial To test the hypothesis that iron supplement from early pregnancy would increase the risk of gestational diabetes mellitus (GDM).Randomised placebo-controlled trial.A university teaching hospital in Hong Kong.One thousand one hundred sixty-four women with singleton pregnancy at less than 16 weeks of gestation with haemoglobin (Hb) level between 8 and 14 g/dl and no pre-existing diabetes (...) weeks (OR: 1.04, 95% confidence interval [CI]: 0.7-1.53 at 90% power) or 36 weeks. Maternal Hb and ferritin levels were higher in the iron supplement group at delivery (P < 0.001 and P= 0.003, respectively). Elective caesarean section rate was lower in the iron supplement group (OR: 0.58, 95% CI: 0.37-0.89). Infant birthweight was heavier (P= 0.001), and there were fewer small-for-gestational-age babies in the iron supplement group (OR: 0.46, 95% CI: 0.24-0.85).Iron supplement from early pregnancy

Gestational Diabetes Mellitus as a Herald of Type 2 Diabetes Mellitus: An Opportunity for a Lifetime 19465213 2009 06 08 2018 11 13 1474-547X 373 9677 2009 May 23 Lancet (London, England) Lancet Gestational diabetes mellitus: an opportunity of a lifetime. 1738-40 10.1016/S0140-6736(09)60958-2 Bentley-Lewis Rhonda R Brigham and Women's Hospital, Division of Endocrinology, Diabetes, and Hypertension, Boston, MA 02115, USA. rbentleylewis@partners.org eng K23 RR023333 RR NCRR NIH HHS United States (...) K23 RR023333-02 RR NCRR NIH HHS United States L32 MD001077 MD NIMHD NIH HHS United States L32 MD001077-03 MD NIMHD NIH HHS United States Comment Journal Article England Lancet 2985213R 0140-6736 AIM IM Lancet. 2009 Aug 29;374(9691):684 19716959 Lancet. 2009 May 23;373(9677):1773-9 19465232 Cohort Studies Diabetes Mellitus, Type 2 epidemiology etiology prevention & control Diabetes, Gestational epidemiology etiology prevention & control Female Health Services Needs and Demand Humans Incidence

Gestational diabetes: the need for a common ground. Gestational diabetes mellitus is a substantial and growing health concern in many parts of the world. Certain populations are especially vulnerable to developing this condition because of genetic, social, and environmental factors. Gestational diabetes has serious, long-term consequences for both baby and mother, including a predisposition to obesity, metabolic syndrome, and diabetes later in life. Early detection and intervention can greatly (...) improve outcomes for women with this condition and their babies. Unfortunately, screening and diagnostic tests are not uniform worldwide, which could lead not only to underdiagnosis but also undermanagement of the illness. Here, we report the controversies surrounding the causes, screening, diagnosis, management, and prevention of gestational diabetes, and give specific recommendations for research studies to address the major issues of this medical condition.