Gestational Diabetes Mellitus Screening

The problem investigators have placed the problem in the context of reports from the International Association of the Diabetes and Pregnancy Study group (IADPSG) of using 75g of OGTT in the diagnosis of GDM. This criterion which was adopted by the World Health Organization and American Diabetes Association among other organizations shows that the researchers have the existing knowledge on diagnoses of GDM (Lai et al. With the research study indicating the lack of knowledge in the role that the maternal age play in screening of GDM, the study, will improve the performance of FPG-based screening hence solves the problem of complications in diagnosing GDM in older, pregnant women. The authors state that the purpose of the study is to “develop a screening algorithm that would take into consideration the maternal age and eventually improve the performance of FPG-based diagnosis of GDM”.

Review of Literature The researchers begin by reviewing the literature that describes gestational diabetes mellitus as “a complication that is developed due to carbohydrate intolerance during pregnancy” (Agarwal, Dhatt & Shah, 2010). 1-hour Plasma glucose during OGTT 1hPG)180mg/dL(10. 0mmol/L);3). 2-hourplasmaglucose During OGTT (2hPG)153mg/dL(8. 5mmol/L). GDM with FPG<92mg/dL(5. Also, physical laboratory examinations and laboratory tests results of the women were recorded. All women, pregnant at this time, underwent a 75g OGTT at a period between 24-28 weeks to diagnose GDM. However, women with overt diabetes were an exemption. Written informed consent was obtained from each patient for the agreement of Chart review to undertake the cohort study. On the other hand, the prospective cohort study for validation was done between a period of November 2013 to March 2015.

In this study, researchers found that the prevalence of GDM with FPG<92mg/dl increased with age that meant that if only FPG criteria would be used to screen GDM, a lot of women who become pregnant at an older age with GDM will be missed (Resnick, Harris, Brock & Harris, 2000). Summary Strengths The authors mention in the second last paragraph that “the strength of this study is the inclusion of two cohort studies in the analyses. Both the effect of the age in the diagnosis of GDM using FPG and the performance of the algorithms were validated in the validation cohort”. Besides that the algorithms for diagnosis of GDM presented in the study paper are simple and practical and can be used clinically in the need of achieving improved performance in the diagnosing of GDM using FGP (Weinert, 2010).

Additionally, the simulation data shows the extended applicability of the algorithms. , & Shah, S. Gestational Diabetes Mellitus: Simplifying the International Association of Diabetes and Pregnancy diagnostic algorithm using fasting plasma glucose.  Diabetes Care, 33(9), 2018-2020. doi: 10. 2337/dc10-0572. 3 Lai, Y. , Li, H. , Hung, C. , Lin, M. , Shih, S. Diagnosis of GDM: A suggested consensus.  Best Practice & Research Clinical Obstetrics & Gynecology, 29(2), 194-205. doi: 10. 1016/j. bpobgyn.  Diabetes Care, 23(2), 176-180. doi: 10. 2337/diacare. 176 Weinert, L. International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy: Comment to the International Association of Diabetes and Pregnancy Study Groups Consensus Panel. Prevalence and Socio demographic and Lifestyle Determinants of Anemia during Pregnancy: A Cross-Sectional Study of Pregnant Women in China.  International Journal Of Environmental Research And Public Health, 13(9), 908.