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Implementing the 2013 WHO diagnostic criteria for gestational diabetes mellitus in a Rural Nigerian Population

机译:实施2013年尼日利亚人口乡村糖尿病妊娠期糖尿病诊断标准

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Introduction:the World Health Organization (WHO) reviewed the threshold values required for the diagnosis of Gestational Diabetes Mellitus (GDM) in 2013 and the implementation of the new diagnostic criteria have been associated with increase in the prevalence of GDM in some populations. The new cohort of pregnant women that will be labeled to have GDM by the 2013 WHO diagnostic criteria but not by the 1999 WHO diagnostic criteria will pose additional burden to specialized antenatal care, though their pregnancy outcome may not warrant such care. It is thus important to first determine the effect of the implementation of these new consensus diagnostic criteria on the prevalence of GDM in our environment.Methods:this is a prospective hospital-based study that compared the implementation of both 1999 and 2013 WHO GDM diagnostic criteria among 117 pregnant women who were initially screened with 50-gram Glucose Challenge Test (50-g GCT). Women with a positive Glucose Challenge Test (GCT) result underwent a 75-gram Oral Glucose Tolerance Test (75-g OGTT), which was used as the actual diagnostic test for GDM using both 2013 WHO and 1999 WHO diagnostic criteria. Associations between variables were tested using Chi-square, Fisher's exact and t-test as appropriate. Significance level was set at P value 0.05.Results:the prevalence rates of GDM in the study were 2.6% and 7.7% for 1999 WHO and 2013 WHO criteria respectively. Clinical characteristics were similar in women with GDM and women without GDM. The fasting component of the OGTT identified all the women with GDM.Conclusion:the implementation of the 2013 WHO diagnostic criteria is associated with a 2.5 to 3-fold rise in the prevalence of GDM. Selective risk-factor based screening may be clinically irrelevant with the adoption of the 2013 WHO diagnostic criteria. A minimum of fasting plasma glucose in resource poor settings can be considered to identify women with GDM since it appeared to have 100% sensitivity in our study.Copyright: Ayokunle Moses Olumodeji et al.
机译:介绍:世界卫生组织(世卫组织)审查了2013年诊断妊娠期糖尿病(GDM)诊断所需的阈值,并且新的诊断标准的实施与某些人口中GDM的普遍增加有关。 2013年将被标记为孕妇的新群组,该妇女将在2013年诊断标准,但不是1999年诊断标准将对专门的产前护理构成额外负担,尽管他们的怀孕结果可能不保证此类护理。因此,重要的是首先确定关于我们环境中GDM的普遍性的实施这些新的共识诊断标准的效果。方法:这是一项基于前瞻性医院的研究,比较了1999年和2013年世界卫生组织GDM诊断标准的潜在医院的研究在117名孕妇中,最初用50克葡萄糖攻击试验(50-G GCT)筛选。患有正葡萄糖挑战试验(GCT)的女性培养了75克口服葡萄糖耐量试验(75-G ogtt),其使用2013年和1999年诊断标准的GDM的实际诊断测试。使用Chi-Square,Fisher的精确和T-Test酌情测试变量之间的关联。重要性水平设定为P值<0.05.结果:1999年,研究的GDM的患病率为2.6%和7.7%,世卫组织和2013年分别为谁标准。患有GDM和女性没有GDM的女性的临床特征类似。 OGTT的禁食部件鉴定了所有具有GDM的妇女。结论:2013年诊断标准的实施与GDM的患病率的2.5倍至3倍。基于选择性风险因素的筛选可能与2013年诊断标准的采用临床无关。资源差的环境中最小的禁食血浆葡萄糖可以被认为是识别具有GDM的女性,因为它在我们的研究中似乎有100%的敏感性。柔小妙语:Ayokunle Moses Olumodeji等人。

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