Bhavadharini B, Uma R, Saravanan P, Mohan V
Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre WHO Collaborating Center for Non-Communicable Disease Prevention and Control, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086 India.
Seethapathy Clinic and Hospital, Chennai, India.
Clin Diabetes Endocrinol. 2016 Jun 1;2:13. doi: 10.1186/s40842-016-0031-y. eCollection 2016.
Gestational diabetes mellitus (GDM) is one of the most common metabolic complications of pregnancy. Ever since the first systematic evaluation of the oral glucose tolerance test by O'Sullivan and colleagues was carried out in 1964, there has been controversy with respect to the optimal screening and diagnostic criteria to detect GDM. The recently proposed International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria for GDM has found fairly widespread acceptance, but it is still debated by several societies. This review intends to provide an overview of the evolution of the screening and diagnostic criteria for GDM. Debatable issues regarding optimal screening strategies, especially in the low resource settings of low and middle income countries are highlighted. The recent Women in India with GDM Strategy (WINGS) project carried out in Chennai, India tried to develop a Model of Care for GDM suitable for resource constrained settings. The findings related to screening and diagnosis of GDM based on WINGS are also highlighted in this review. Based on the WINGS experience we believe that despite the constraints in low and middle income countries at the present time, the IADPSG criteria appears to be the best. This will also help to bring out a uniform criteria for screening and diagnosis of GDM worldwide.
妊娠期糖尿病（GDM）是妊娠最常见的代谢并发症之一。自1964年奥沙利文及其同事首次对口服葡萄糖耐量试验进行系统评估以来，关于检测GDM的最佳筛查和诊断标准一直存在争议。最近提出的国际糖尿病与妊娠研究组（IADPSG）的GDM诊断标准已得到相当广泛的认可，但仍受到一些学会的争议。本综述旨在概述GDM筛查和诊断标准的演变。文中强调了关于最佳筛查策略的争议性问题，尤其是在低收入和中等收入国家的资源匮乏地区。最近在印度金奈开展的“印度GDM女性策略（WINGS）”项目试图制定一种适用于资源受限环境的GDM护理模式。本综述还强调了基于WINGS项目得出的与GDM筛查和诊断相关的研究结果。基于WINGS项目的经验，我们认为尽管目前低收入和中等收入国家存在诸多限制，但IADPSG标准似乎是最佳选择。这也将有助于在全球范围内制定统一的GDM筛查和诊断标准。
