Screening for gestational diabetes mellitus

It has been estimated that diabetes affects an estimated 415 million people globally and is projected to increase to 642 million by 2040.

There is also an equally high burden of prediabetes, approximately 318 million people and likely to increase to 481 million by 2040.

These findings are accompanied by high levels of overweight and obese adults. The WHO data show that more than half of the world’s adult population was overweight (39%) or obese (13%), including an estimated 42 million pregnant women.

Hyperglycaemia in pregnancy (HIP) is a broad term that encompasses various forms of glucose dysregulation seen during pregnancy [DM T1, DMT2, gestational diabetes mellitus (GDM)]

GDM is a condition with abnormal glucose intolerance diagnosed for the first time during pregnancy at routine testing.

The international Diabetes Federation has estimated that 21 million live births—one in six (16.8%)—occur in women with some form of HIP, of which 2.5% may be due to overt diabetes in pregnancy. The remaining 14.3% (one in seven pregnancies) is due to GDM.

More than one third of people with diabetes and a majority of people with prediabetes remain undiagnosed and unaware of the condition.

The diagnosis is most often made in the second and third trimester by an oral glucose tolerance test.

GDM affects up to almost 20% of the pregnancies in Europe.

Besides glucosuria, women with GDM most often do not have any signs of the condition, unless there is excessive foetal growth that influences the well-being of the women.

Women diagnosed with GDM are at increased risk of excessive foetal growth and birth complications.

Women developing GDM may be more insulin resistant even before pregnancy or may not be capable of increasing Insulin secretion sufficiently to maintain a normal glucose tolerance throughout pregnancy.