妊娠期糖尿病病人产后糖代谢转归及其相关因素分析

目的:探讨妊娠期糖尿病(GDM)病人产后糖代谢转归及其影响因素,为预防GDM病人产后糖代谢异常提供参考.方法:选择GDM病人931例并收集临床资料,在产后6~12周跟踪糖代谢转归情况,对GDM病人产后糖代谢异常的相关因素进行分析.结果:931例病人产后6~12周出现糖代谢异常者占33.08%(308/931),其中糖尿病35例,空腹血糖调节受损14例,空腹血糖调节受损+葡萄糖耐量降低7例,葡萄糖耐量降低252例.GDM病人产后糖代谢异常组孕期口服葡萄糖耐量试验(OGTT)中空腹血糖(FPG)、服糖2 h后血糖(2hPG)、服药3 h后血糖(3hPG)均高于正常组(P<0.01),新生儿体质量低于正常组(P<0.01).单因素分析提示,OGTT FPG、2hPG、3hPG和新生儿体质量均是GDM病人产后糖代谢异常的影响因素.多因素分析显示,孕期OGTT的FPG、2hPG、3hPG是产后糖代谢异常的独立危险因素.OGTT FPG(OR=3.528)、OGTT 2hPG(OR=1.579)和OGTT 3hPG(OR=1.655)越高,产后糖代谢异常的风险越高.结论:部分GDM病人产后会出现糖代谢异常,与孕期OGTT结果密切相关,应针对性做好随访管理和防控措施.     

强化饮食管理的妊娠期糖代谢异常孕妇的产后随访研究

目的 探讨强化饮食管理的妊娠期糖代谢异常孕妇产后42 d血糖异常的相关因素和预防措施.方法 111例孕30周前确诊为妊娠期糖代谢异常[包括妊娠期糖尿病(GDM)和妊娠期糖耐量受损(GIGT)]孕妇,在营养门诊定期强化饮食管理,于分娩后42 d行75 g葡萄糖耐量试验(OGTT),按世界卫生组织标准进行再分类,即2型糖尿病(T2DM)、糖耐量减低(IGT)、空腹血糖受损(IFG)和血糖正常.选择同期未接受强化饮食管理的妊娠期糖代谢异常孕妇72例做对照,对比二者的随访率.结果 111例中有84例进行了产后42 d糖代谢检查,随访率为75.68%(84/111),明显高于未强化饮食管理者的随访率37.50%(27/72),差异有统计学意义(P＜0.05).强化饮食管理的妊娠期糖代谢异常孕妇产后42 d有51例(60.71%)血糖正常(Ⅰ组),33例(39.29%)血糖异常(Ⅱ组),其中7例(8.33%)为T2DM、24例(28.57%)为IGT、2例(2.38%)为IFG.GDM孕妇中产后42 d糖代谢异常发生率为52.78%(19/36),GIGT孕妇中产后42 d糖代谢异常发生率为29.17%(14/48),差异有统计学意义(χ2=4.8081,P＜0.05).多元线性回归分析结果 显示,影响产后42 d空腹血糖和OGTT餐后2 h血糖的因素有糖尿病家族史和确诊时OGTT异常项数.结论 强化饮食管理的妊娠期糖代谢异常孕妇产后随访率高;有家族史的GDM孕妇产后血糖异常发生率较高.应重视产后随访,并根据相关因素给予积极干预.     

妊娠期糖尿病孕妇分娩后血糖异常的相关因素研究

目的:探讨妊娠期糖尿病孕妇分娩后引发血糖异常的相关因素。方法:本次选取50例围产期保健及分娩的妊娠期糖尿病孕妇,于产后不同时间段行75g葡萄糖耐量试验,依据检测结果按糖代谢异常组和正常组划分,分析影响产后糖代谢的因素。结果:分娩后8周,GDM孕妇糖代谢异常率为34%,6个月为30%,1年为18%。异常组诊断GDM孕周较正常组早,糖化血红蛋白(Hb Alc)、OGTT2h血糖、空腹血糖(FPG)、GCT血糖均高于正常组,差异有统计学意义(P<0.05)。结论:对GDM的孕周诊断的越早,取胰岛素在孕期控制血糖,产后高脂血症等,均为影响产后糖代谢恢复因素,故需加强此类人群重视,完善产后血脂、血糖随诊及孕期营养健康管理,以延迟或预防糖尿病发生。     

妊娠期糖尿病孕妇产后血糖随访结果分析

目的:探讨妊娠期糖尿病(GDM)孕妇产后6周的75g葡萄糖耐量试验(OGTT)结果了解产后DM的发生率.方法:对115例GDM孕妇于产后6周行OGTT,按WHO标准进行再分类,分为正常组、糖耐量减低(IGT)组、糖尿病(DM)组.结果:115例产妇中血糖正常组86例,占74.8%;IGT组19例,占16.5%;DM组10例,占8.7%.结论:GDM孕妇产后糖代谢异常发生率高,是发生DM的高危人群,产后应定期随访,以便及早诊断糖尿病.     

妊娠期糖尿病孕妇产后血糖随访结果分析

①目的探讨妊娠期糖尿病（GDM）孕妇产后2个月75g葡萄糖耐量（OGTT）试验结果及其相关的临床因素。②方法对98例GDM孕妇于产后2个月行OGTT试验，根据结果进行再分类，分为糖尿病（DM）组21例、糖耐量减低（IGT）组24例和血糖正常组53例，对其相关的临床因素进行分析。③结果DM组诊断为GDM的孕周早于其他两组，孕期的50g葡萄糖筛查试验（GCT）血糖水平及OGTT中的空腹血糖水平均高于其他两组，差异有显著性（F=4．40～8．30，q=3．19～5．75，P〈0．05）。DM组孕妇胰岛素使用率高于正常组（χ^2=5．47，P〈0．05），开始使用胰岛素孕周早于其他两组（F=4．97，q=4．39、3．19，P〈0．01）。④结论GDM孕妇中表现为发病早、GCT血糖值高、空腹血糖高、胰岛素使用率高者常预示产后糖代谢异常将持续存在。     

妊娠糖代谢异常孕妇产后转归及相关因素分析

目的分析妊娠糖代谢异常孕妇产后6～8周的75g葡萄糖耐量试验（OGTT）的结果,探讨其相关因素。方法采用回顾性研究的方法,2006年6月～2007年12月在我院分娩并确诊为妊娠糖代谢异常的孕妇213例,于产后6～8周行75gOGTT,按WHO标准进行再分类,分为糖尿病（DM）、糖耐量低减（IGT）和正常糖耐量（NGT）,并对其相关因素进行分析。结果（1）213例妊娠糖代谢异常孕妇中产后6～8周有90例（42．3％）血糖正常（OGTT正常组）,123例（57．7％）AL糖异常（OGTT异常组）,其中90例（42．3％）IGT,33例（15．5％）DM。（2）与正常组比较,OGTT异常组有糖尿病家族史所占比例较高（P=0．01）;在孕期妊娠糖代谢异常的诊断孕周较早（P〈0．01）;50g葡萄糖负荷试验（GCT）时的血糖、OGTT中的空腹血糖以及诊断时的糖化血红蛋白（HbA1c）均较高（P〈0．05～0．01）;孕期胰岛素治疗所占比例较高（P〈0．05）。结论超过一半的妊娠糖代谢异常孕妇产后仍有糖代谢异常,多表现为在孕期发病早,空腹血糖高,使用胰岛素机会多且多有糖尿病家族史。     

妊娠期糖尿病孕妇产后糖代谢异常情况分析

目的分析妊娠期糖尿病(GDM)患者产后6⁸周内糖代谢异常情况。方法选取2011年5月至2012年12月深圳市南山妇幼保健院确诊的GDM并正常分娩的患者119例作为研究对象,根据患者产后68周内糖代谢异常情况。方法选取2011年5月至2012年12月深圳市南山妇幼保健院确诊的GDM并正常分娩的患者119例作为研究对象,根据患者产后6⁸周糖代谢恢复情况分为糖代谢异常组和糖代谢正常组。观察两组患者的母乳喂养率、口服葡萄糖耐量试验(OGTT)分时测量值以及胰岛素使用情况。结果糖代谢正常组患者诊断孕周较晚、空腹血糖水平较低、BMI较低、孕次及产次均显著少于糖代谢异常组(P<0.01);糖代谢正常组患者母乳喂养率显著高于糖代谢异常组(P<0.05),OGTT分时测量值均显著低于糖代谢异常组(P<0.01);糖代谢正常组饮食控制率显著高于糖代谢异常组,但胰岛素使用情况显著低于糖代谢异常组(P<0.01)。结论孕妇既往史及孕前资料、孕期糖代谢水平及诊断孕周、产后治疗及婴儿喂养方式等均可影响产妇产后糖代谢水平变化。     

妊娠期糖尿病的早期筛查与护理干预

妊娠期糖尿病(gestational diabetes mellitus,GDM)是指妊娠期首次发现或发生的糖代谢异常,约占妊娠合并糖尿病的80%～90%[1].妊娠期糖耐量异常(gestational impaired glucose tolerance,GIGT)为早期血糖稳态的改变,是介于正常血糖和GDM之间的中间状态或过渡阶段.妊娠期糖代谢异常包括GDM和GIGT,1979年WHO将GDM列为糖尿病的一个特殊类型[2].     

妊娠期糖尿病孕妇产后高血糖的危险因素分析

  目的  了解妊娠期糖尿病(GDM)孕妇产后高血糖情况,并分析GDM孕妇产后高血糖的影响因素。  方法  选取2017年5月—2020年2月在海南省文昌市人民医院门诊就诊的GDM孕妇206例,根据产后2个月的75 g口服葡萄糖耐量试验(OGTT)结果分为产后高血糖组(54例)和产后血糖正常组(152例)。收集2组孕妇的一般临床资料,对其产后高血糖发生的影响因素进行分析。  结果  206例GDM孕妇产后发生高血糖共54例,产后高血糖发生率为26.21%。单因素分析结果显示,年龄、孕期BMI、巨大胎儿、糖尿病(DM)家族史、孕期OGTT异常项次、孕期使用胰岛素治疗、产后BMI、孕期空腹血糖水平、产后运动与GDM孕妇产后高血糖相关(均P < 0.05);经logistic回归分析显示,年龄(OR=2.261, P=0.023)、DM家族史(OR=3.865, P=0.001)、产后BMI(OR=2.502, P=0.020)、孕期空腹血糖(OR=2.130, P=0.029)、孕期OGTT异常项次增多(OR=4.864, P < 0.001)、孕期使用胰岛素治疗(OR=3.251, P=0.001)是GDM孕妇产后高血糖的独立影响因素。  结论  年龄、DM家族史、产后BMI、孕期OGTT异常项次增多、孕期空腹血糖、孕期使用胰岛素治疗是GDM孕妇产后高血糖的独立影响因素,临床上应采取积极的干预措施,预防产后高血糖的发生。      

妊娠糖代谢异常的发病危险因素及产后转归调查研究

目的：了解包头地区妊娠糖代谢异常的发病率、危险因素及产后转归情况。方法：对875例孕妇进行50 g GCT和75 g OGTT筛查,分析妊娠糖耐量异常的危险因素,并对糖代谢异常孕妇进行产后6~8周随访。结果：875例孕妇筛查结果显示,妊娠糖耐量减低（GIGT）5.4%,妊娠糖尿病（GDM）3.5%。多因素Logistic回归分析显示年龄、hsCRP是妊娠糖代谢异常的危险因素。糖代谢异常孕妇产后34.3%仍存在糖代谢异常,其中GDM患者产后53.5%仍存在糖代谢异常,GIGT患者产后20.5%仍存在糖代谢异常。产后转归为T2DM的ISSI最低（P〈0.05）,T2DM与糖调节受损的ISI-Matsuda均比NGT低（P〈0.01）。结论：孕期糖代谢紊乱越重,产后仍存在糖代谢异常的可能性越大;胰岛素抵抗是产后发生糖代谢异常的主要发病机制,而胰岛β细胞分泌功能缺陷可能是GDM孕妇产后早期发生T2DM的主要原因。     

Risk factors for development of diabetes mellitus in women with a history of gestational diabetes mellitus

Objective To determine whether diabetes recurs in their later life when women have a history of gestational diabetes mellitus (GDM) or abnormal glucose tolerance test (impaired glucose tolerance, IGT). Methods Three groups of women were investigated at 5-10 years postpartum. GDM group (n=45) had been diagnosed as having GDM in their previous pregnancy. IGT group (n=31) had a history of abnormal glucose tolerance test during previous pregnancy. Normal control group (n=39) was normal previous pregnant population. Their previous obstetric and medical histories were thoroughly reviewed. Fasting plasma glucose (FPG) and oral glucose (75 g) tolerance test (OGTT) were repeated in all women. Results Diabetes mellitus (DM) was diagnosed in 33.3% of patients in the GDM group, while in 9.7% in the IGT group and in 2.6% in the normal control group. Incidence of recurring DM in later life was significant higher in the GDM group (P=0.017). When one or more blood glucose values exceeding WHO criteria for diagnosis of diabetes in their previous pregnancy, the incidence of DM in later life was 60% (3/5, including GDM in women having four abnormal OGTT values), 41.7% (5/12) in women having three, 25% (7/28) in women having two and 9.7% (3/31) in women having one. The women with DM, also with a history of GDM and abnormal OGTT in previous pregnancy, tends to have a high pregnant body mass index (BMI &gt;25 kg/m(2)). Conclusion The women suffering from GDM during previous pregnancy have a high risk of recurrence DM. Two or more abnormal OGTT values during pregnancy, blood glucose level exceeding the maximal values at 1 and 2 hours after oral glucose loading and high pregnant BMI are concluded to be useful factors in predicting the recurring DM in their later life.     

Risk factors for development of diabetes mellitus in women with a history of gestational diabetes mellitus

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不同体型孕妇脂肪因子Chemerin与妊娠糖尿病糖脂代谢的研究

目的:探讨孕前不同体型孕妇的脂肪因子Chemerin及脂质代谢情况与妊娠糖尿病相关关系。方法:选取2018年10月—2019年10月在内蒙古科技大学包头医学院第一附属医院产科门诊定期产检及住院待产的孕妇,参照2013年WHO诊断标准于孕24~28周诊断为妊娠糖尿病(GDM)患者60例,根据孕前体质量指数(BMI)水平分为标准组(BMI 18.5~23.9 kg/m²)、超重组(BMI 24~28 kg/m²)、肥胖组(BMI≥28 kg/m²),每组20例;另外选取血糖正常、BMI为18.5~23.9 kg/m²的孕妇20例作为对照组,所有入选对象均于37~40周分娩。入院后详细记录孕妇年龄、身高、孕前体重;同时分别测定各组分娩前空腹血糖、空腹胰岛素、糖化血红蛋白、血脂(总胆固醇、甘油三酯、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇)、超敏CRP(hs-CRP),并计算胰岛素抵抗指数(HOMA-IR),用酶联免疫吸附法测定外周血Chemerin值。结果:GDM三组Chemerin、空腹血糖、空腹胰岛素、糖化血红蛋白、HOMA-IR、甘油三酯、低密度脂蛋白胆固醇、hs-CRP检测值均高于正常对照组;GDM超重组、GDM肥胖组Chemerin、空腹血糖、空腹胰岛素、糖化血红蛋白、HOMA-IR、hs-CRP高于GDM标准组;GDM肥胖组甘油三酯、低密度脂蛋白胆固醇高于GDM标准组。结论:孕前超重及肥胖体型的GDM孕妇糖脂代谢异常、炎症增加,代谢综合征风险增高。     

2型糖尿病HDL2b的变化特点及对预测冠心病风险的意义

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清高密度脂蛋白(high-density lipoprotein,HDL)亚组分HDL2b的变化特点及对预测冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)风险的意义。方法采用病例对照研究的方法观察41例T2DM患者及41例空腹血糖正常(normal fasting glucose,NFG)对照者,病例均来自于北京市顺义区南法信镇35～74岁自然人群,2组研究对象的年龄、性别、体质量指数(body mass index,BMI)、腰围、臀围、血压均匹配,采用微流芯片(microfluidic chip)技术测定空腹血清HDL、HDL2b、HDL2b/HDL比率,并对10年CHD发生风险(10-year CHD risk)进行评估。结果 T2DM组患者空腹血糖(fasting plasma glucose,FPG)、稳态模型胰岛素敏感指数(homeostasis model for insulin resistance,HOMA-IS)、胰岛素抵抗指数(homeostasis model assessment-insulin resistant index,HOMA-IR)、三酰甘油(triglycerides,TG)、血清总胆固醇(total cholesterol,TC)、10年CHD发生风险均显著高于对照组(P<0.05),HDL、HDL2b、HDL2b/HDL比率显著低于对照组(P<0.01),HDL2b与FBG、空腹胰岛素(fasting insulin,FINS)、TG、TC、HOMA-IR、10年CHD发生风险呈负相关,HDL2b与FBG及10年CHD发生风险相关性优于HDL。结论 T2DM患者HDL2b显著降低,10年CHD发生风险显著上升,与HDL相比,HDL2b预测CHD发生风险更加敏感。     

妊娠粮尿病代谢特征与产后粮代谢异常关系分析

目的研究妊娠糖尿病（GDM）患者临床代谢特征与产后早期持续糖代谢异常之间的关系。方法选取孕24～36周妊娠糖尿病患者63例,同期糖代谢正常孕妇30例作对照。分别测定两组空腹及75g葡萄糖负荷后血糖、胰岛素和血游离脂肪酸水平（FFA）,同时测定空腹状态下血超敏C反应蛋白（Hs-CRP）、血脂谱、糖化血红蛋白等指标,计算孕前体重指数、新稳态模型胰岛素抵抗指数（HOMA2-IR）、新稳态模型胰岛B细胞功能指数（HOMA2-％B）、早期胰岛素分泌指数（△130／AG30）、早期FFA降低比率（△FFA30／△FFA0）、FFA曲线下面积（AUCFFA）,并记录糖尿病家族史;同时于产后6～8周,对所有妊娠糖尿病患者再次行75g葡萄糖负荷试验以判定产后糖代谢情况,并分为正常对照组（NC）、产后糖调节正常组（NGR）和产后糖调节异常组（AGR）。结果17例GDM患者于产后6～8周仍持续存在糖代谢异常。占总随访例数的29％。对比NC组和NGR组孕期各项临床代谢指标,显示AGR组有明显升高的孕前BMI、HbA1C、空腹血糖、Hs-CRP。3组间血脂谱及糖尿病家族史分布的差异无统计学意义。AGR组胰岛素抵抗明显升高、13细胞功能减退。AGR组空腹、OGTT2h后血FFA及AUCFFA明显高于NC组和NGR组。NC组的△FFA30／AFFA0为25％,高于NGR组的18％和AGR组的15％（均P〈0．05）。Logistic回归分析显示：孕前BMI升高、AUCFFA升高和HOMA2一％B下降是妊娠糖尿病患者产后持续血糖异常的危险因素。结论有相当部分的GDM患者产后持续存在糖代谢异常。孕前BMI、胰岛B细胞功能缺陷和血FFA水平升高可能是GDM患者产后持续血糖升高的主要危险因素。     

妊娠期糖尿病高危因素与产后早发糖代谢异常的关系

【目的】探讨妊娠期糖尿病(GDM)传统高危因素与妊娠结局及产后早发糖代谢异常的关系&#65377;【方法】 3 017名孕妇以高危因素或50 g葡萄糖筛查试验进行GDM筛查,阳性者行75 g 口服葡萄糖耐量试验(OGTT)确诊GDM,GDM孕妇分为高危因素组(G1组, n = 143)与非高危因素组(G2组,n = 175),并于产后6 ~ 8周及产后6 ~ 12月复查OGTT&#65377; 【结果】 3 017名孕妇中318例确诊GDM,存在高因危素的孕妇GDM患病率明显高于无高危因素的孕妇(41.81% VS 6.54%, P < 0.01),且分娩期并发症发生率&#65380;早产率以及胎儿体质量更高,产后6 ~ 12个月持续糖代谢异常率亦明显升高&#65377;Logistic回归分析显示糖尿病家族史&#65380;尿糖阳性与产后糖代谢异常相关&#65377; 【结论】 存在GDM高危因素的孕妇GDM患病率明显升高,产后持续糖代谢异常的概率亦显著升高,其中尿糖阳性与糖尿病家族史有较高的相关性&#65377;     

Beta-cell dysfunction is the primary contributor to the early postpartum diabetes among Chinese women with history of gestational diabetes mellitus

Background Women with a history of gestational diabetes mellitus （GDM） are at higher risk of future development of diabetes. This study investigated the risk factors associated with early postpartum abnormal glucose regulation （AGR） among Chinese women with a history of GDM.
Methods A total of 186 women with a history of GDM were screened for early postpartum AGR at 6-8 weeks after delivery. Those with AGR were given lifestyle intervention therapy and reevaluated in 6-12 months. The demographic, anthropometric, prenatal and delivery data were recorded. The plasma high-sensitivity C-reactive protein （HsCRP） and lipid concentration were measured, and insulin secretion were analyzed. Insulinogenic index △ins30＇/△BG30＇, the homeostasis model assessment index （HOMA）-B, and HOMA-IR were calculated. Multiple regression analysis was performed to identify the risk factors.
Results Of the GDM women 28.0% （52/186） had AGR at 6-8 weeks after delivery; 45.2% （17/40） of these AGR women reminded abnormal after 6-12 month lifestyle intervention. Compared to the women who reverted to normal, women with consistent AGR showed significantly lower fasting insulin concentration, lower △ins30＇/△BG30＇ as well as lower HOMA-B. No significant differences in age, body mass index （BMI）, waist circumference, blood pressure, lipid level HsCRP and HOMA-IR were observed between the two groups. Pre-pregnancy BMI ≥25 kg/m^2, fasting glucose level ≥5.6 mmol/L and/or 75 g oral glucose tolerance test （OGTT） 2 hours glucose level ≥11.1 mmol/L during pregnancy were predictors for the AGR at 6-8 weeks after delivery. △ins30＇/△BG30≤1.05 was a significant risk contributor to the consistent early postpartum AGR.
Conclusion There is a high incidence of early postpartum AGR among Chinese woman with prior GDM. Beta-cell dysfunction, rather than insulin resistance or inflammation, is the predominant contributor to the early onset and consistent AGR after delivery.     

血清性激素结合球蛋白水平与妊娠期糖耐量异常相关性研究

目的：通过比较SHBG水平在各孕周及不同程度糖耐量异常孕妇及相应孕周正常孕妇血清中的变化,探讨SHBG与妊娠期糖耐量异常相关性。方法：通过两步法筛选出不同程度糖耐量异常孕妇做实验组,选取相应孕周孕妇为对照组,测定其空腹血糖及SHBG水平并分析数据。结果：（1）在正常孕妇中SHBG浓度在孕期比非孕期显著增加,GDM组孕妇各孕周血中SHBG浓度均明显低于同孕周正常对照组,差异显著（P〈0.05）,且在小于妊娠24周及产后组中有极显著性差异（P〈0.01）。（2）在正常孕妇、单纯GCT阳性、糖耐量减低及GDM孕妇中,GDM组的SHBG浓度明显低于其他三组,差异显著（P〈0.05）;正常孕妇组的SHBG浓度明显高于其他三组,差异显著（P〈0.05）糖耐量异常组SHBG浓度低于单纯糖负荷试验异常组,但无统计学意义（P〉0.05）。结论：（1）在妊娠早中期测定SHBG浓度可以预测GDM,产后的SHBG水平对于判断GDM的预后也有重要的作用。（2）SHBG的降低与妊娠期糖耐量异常程度密切相关,通过孕期SHBG浓度的测定可以预知GDM的潜在人群,判定GDM的发生、发展及严重程度。     

A comparative study of the different diagnostic criteria of gestational diabetes mellitus and its incidence

Background

High prevalence of diabetes and genetic predisposition to metabolic syndrome among Indians places Indian women at risk to develop gestational diabetes mellitus (GDM) and its complications. Literature defines multiple criteria for GDM. This prospective study compares available diagnostic criteria for GDM in Indian women and their correlation with perinatal morbidity.

Method

Nine hundred and forty-eight consecutive voluntary nondiabetic pregnant women were recruited for the study. Seven hundred and twenty-three of these (mean age 23.45 years; 75.7% < 25 years) who reported for the follow-up were screened for GDM at 24–28 weeks gestation by American College of Obstetrics and Gynaecology (ACOG) guidelines and World Health Organization (WHO) criteria. Glycated haemoglobin (HbA_1c) and fasting and two-hours postglucose plasma insulin levels were also analysed. Pregnancy outcome was known for 291 of these. Concordance of risk factors and perinatal complications was analysed with respect to GDM.

Results

Prevalence of GDM at 24–28 weeks gestation was found to be 4.8% by WHO criteria, 6.36% by Carpenter and Coustan's criteria, and 3.5% by O'Sullivan's criteria. Prevalence was marginally higher in women of higher age, having past history of abortion or family history of diabetes mellitus (DM) (P > 0.05). None of these women had HbA_1c > 6%. Relative risk of abnormal delivery (pregnancy outcome) was 1.93, 1.39, and 1.17 in women with GDM by O'Sullivan's, WHO, and Carpenter's criteria, respectively (P > 0.05). Abnormal deliveries were marginally higher in women with high postglucose load insulin levels. Mean weight of the newborns was essentially the same in GDM and nonGDM women by any of the criteria. One-hour and two-hours postglucose values were more sensitive in diagnosing GDM by O'Sullivan's criteria while fasting plasma glucose value had the poorest specificity with 2.5% of nonGDM women having values above the cut-off. Modifications of these criteria did not im-prove their predictive value for abnormal delivery over that of O'Sullivan's criteria.

Conclusion

Prevalence of GDM and abnormal delivery in women < 35 years of age is low. Therefore, global screening for GDM may not be very useful in women < 25 years of age unless family history of DM or past history of abortion is present. Existing evidence is inadequate to justify the switchover from O'Sullivan's criteria for diagnosis of GDM.