Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?
The incidence of gestational diabetes mellitus (GDM) is increasing worldwide. This has a significant effect on the health of the mother and offspring. There is no doubt that screening for GDM between 24 and 28 weeks is important to reduce the risk of adverse pregnancy outcomes. However, there is no...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/6/1257 |
| _version_ | 1797540911496822784 |
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| author | Lore Raets Kaat Beunen Katrien Benhalima |
| author_facet | Lore Raets Kaat Beunen Katrien Benhalima |
| author_sort | Lore Raets |
| collection | DOAJ |
| description | The incidence of gestational diabetes mellitus (GDM) is increasing worldwide. This has a significant effect on the health of the mother and offspring. There is no doubt that screening for GDM between 24 and 28 weeks is important to reduce the risk of adverse pregnancy outcomes. However, there is no consensus about diagnosis and treatment of GDM in early pregnancy. In this narrative review on the current evidence on screening for GDM in early pregnancy, we included 37 cohort studies and eight randomized controlled trials (RCTs). Observational studies have shown that a high proportion (15–70%) of women with GDM can be detected early in pregnancy depending on the setting, criteria used and screening strategy. Data from observational studies on the potential benefit of screening and treatment of GDM in early pregnancy show conflicting results. In addition, there is substantial heterogeneity in age and BMI across the different study populations. Smaller RCTs could not show benefit but several large RCTs are ongoing. RCTs are also necessary to determine the appropriate cut-off for HbA1c in pregnancy as there is limited evidence showing that an HbA1c ≥6.5% has a low sensitivity to detect overt diabetes in early pregnancy. |
| first_indexed | 2024-03-10T13:07:48Z |
| format | Article |
| id | doaj.art-7ab19b1b1d1f451ba22f4941f2ad6480 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T13:07:48Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7ab19b1b1d1f451ba22f4941f2ad64802023-11-21T11:00:06ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-01106125710.3390/jcm10061257Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence?Lore Raets0Kaat Beunen1Katrien Benhalima2Department of Clinical and Experimental Endocrinology, KU Leuven, Herestraat 49, 3000 Leuven, BelgiumDepartment of Clinical and Experimental Endocrinology, KU Leuven, Herestraat 49, 3000 Leuven, BelgiumDepartment of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, BelgiumThe incidence of gestational diabetes mellitus (GDM) is increasing worldwide. This has a significant effect on the health of the mother and offspring. There is no doubt that screening for GDM between 24 and 28 weeks is important to reduce the risk of adverse pregnancy outcomes. However, there is no consensus about diagnosis and treatment of GDM in early pregnancy. In this narrative review on the current evidence on screening for GDM in early pregnancy, we included 37 cohort studies and eight randomized controlled trials (RCTs). Observational studies have shown that a high proportion (15–70%) of women with GDM can be detected early in pregnancy depending on the setting, criteria used and screening strategy. Data from observational studies on the potential benefit of screening and treatment of GDM in early pregnancy show conflicting results. In addition, there is substantial heterogeneity in age and BMI across the different study populations. Smaller RCTs could not show benefit but several large RCTs are ongoing. RCTs are also necessary to determine the appropriate cut-off for HbA1c in pregnancy as there is limited evidence showing that an HbA1c ≥6.5% has a low sensitivity to detect overt diabetes in early pregnancy.https://www.mdpi.com/2077-0383/10/6/1257pregnancygestational diabetes mellitusearly screeningdiabetes |
| spellingShingle | Lore Raets Kaat Beunen Katrien Benhalima Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence? Journal of Clinical Medicine pregnancy gestational diabetes mellitus early screening diabetes |
| title | Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence? |
| title_full | Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence? |
| title_fullStr | Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence? |
| title_full_unstemmed | Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence? |
| title_short | Screening for Gestational Diabetes Mellitus in Early Pregnancy: What Is the Evidence? |
| title_sort | screening for gestational diabetes mellitus in early pregnancy what is the evidence |
| topic | pregnancy gestational diabetes mellitus early screening diabetes |
| url | https://www.mdpi.com/2077-0383/10/6/1257 |
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