DIAGNOSIS AND SCREENING METHODS IN GESTATIONAL DIABETES MELLITUS
Gestational Diabetes: From Diagnosis to Treatment, NOVA Publications , ss.205-224, 2020
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2020
- Yayınevi: NOVA Publications
- Sayfa Sayıları: ss.205-224
- Anahtar Kelimeler: Diagnosis, Diagnostic criteria, Gestational diabetes mellitus, Oral glucose tolerance test, Screening
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Gestational diabetes mellitus (GDM) is defined as abnormal glucose tolerance manifesting in the second half of pregnancy. Hyperglycemia in pregnancy is associated with short- and long- term adverse maternal and fetal outcomes. It is important to screen, diagnose and treat hyperglycemia in pregnancy in order to prevent adverse outcomes. Despite the work of many international health organizations including those of obstetrics and endocrinology and years of research dedicated to GDM there is still no consensus on a uniform global approach to screening and diagnosing GDM. There is no consensus regarding screening methods (use of the one-step versus the two-step), screening tools (fasting plasma glucose or random glucose or oral glucose tolerance test), screening aproaches (uviversal or high risk screening), the amount of glucose load (75 or 100 gram glucose), duration of test (2 or 3 hour) and appropriate diagnostic criteria (IADPSG, Carpenter and Coustan, other) needed to make the diagnosis of GDM. Currently, most guidelines recommend an oral glucose tolerance test between 24 and 28 gestational weeks as the method of diagnosis for GDM. Universal screening for all pregnant women at 24-28 gestational weeks appears to be the most practical approach adopted by many authors. The criteria for diagnosing GDM, have evolved over time and the most commonly preferred criteria worldwide are IADPSG criteria followed by C-C criteria. Currently accepted recommendations for screening in early pregnancy for diabetes mellitus (DM) are based on risk stratification. This chapter aims to provide an update on screening and diagnostic strategies for GDM.