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Screening and Diagnosis of Gestational Diabetes Mellitus
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Screening and Diagnosis of Gestational Diabetes Mellitus

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (20 May 2022) | Viewed by 9453

Special Issue Editor

Dr. Basilio Pintaudi

E-Mail Website
Guest Editor
Diabetes Center, Niguarda Hospital, Piazza Ospedale Maggiore, 3 - 20162 Milan, Italy
Interests: GDM screening; GDM diagnosis; technology in pregnancy; pharmacological treatment in pregnancy; nutraceuticals; therapy for type 1 and type 2 diabetes; guidelines
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gestational diabetes screening and diagnosis is a controversial area. For many years, all over the world, a single choice of the best diagnosis method has not been established. The screening and diagnosis procedures depend, in some cases, on the availability of local resources, and in other cases, on the national recommendations of scientific societies. The result is a non-agreement on the strategies to be adopted, with consequent heterogeneity in the therapeutic approach. In some cases, even women at low risk of developing gestational diabetes are labeled as suffering from this condition and are initiated into a treatment path that involves the medicalization of pregnancies otherwise considered as physiological. The sensitivity and specificity of the diagnostic procedures have been the subject of scientific research, sometimes highlighting some critical issues in the selection of women who need to undergo diagnostic tests. However, a definitive conclusion has not yet been reached. However, the ultimate goal should be to improve the neonatal outcome by ensuring cost-effective screening and diagnosis procedures.

Dr. Basilio Pintaudi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gestational diabetes
  • screening
  • diagnosis
  • sensitivity
  • specificity
  • pregnancy outcomes
  • cost-effectiveness

Published Papers (5 papers)

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Research

7 pages, 224 KiB  
Article
Diagnosing Gestational Diabetes with a Probably Too Simplified Diagnostic Procedure Compared to International Criteria: The Indian Case Study
by Francesco Corrado, Antonino Di Benedetto, Giacoma Di Vieste, Laura La Fauci, Canio Martinelli, Rosario D’Anna and Basilio Pintaudi
J. Clin. Med. 2022, 11(13), 3745; https://doi.org/10.3390/jcm11133745 - 28 Jun 2022
Viewed by 1224
Abstract
Diagnostic procedures for the diagnosis of gestational diabetes mellitus (GDM) are not uniformly defined worldwide. We retrospectively applied two diagnostic procedures (i.e., the IADPSG and the Indian) to the same pregnant women in order to compare the clinical characteristics and the prevalence of [...] Read more.
Diagnostic procedures for the diagnosis of gestational diabetes mellitus (GDM) are not uniformly defined worldwide. We retrospectively applied two diagnostic procedures (i.e., the IADPSG and the Indian) to the same pregnant women in order to compare the clinical characteristics and the prevalence of risk factors for GDM. Overall, 1015 pregnant women were evaluated. GDM was diagnosed in 113 cases (11.1%) by the IADPSG criteria and in 105 cases (10.3%) by the Indian criteria. The women diagnosed with GDM according to the IADPSG criteria had higher pre-gestational BMIs, higher previous macrosomia rates, higher first trimester fasting blood glucose levels, higher fasting and 1 h glucose levels after glucose load at OGTT, and lower 2 h glucose levels at OGTT compared with the women with GDM diagnosed according to the Indian criteria. Only 49.6% of the women who were diagnosed by the IADPSG criteria were also diagnosed with GDM by the Indian diagnostic criteria. For 47.8% of the women who were diagnosed by the IADPSG criteria, a diagnosis of GDM was missed by applying the Indian diagnostic criteria. Interestingly, 49 women were diagnosed with GDM by the Indian criteria but were normal according to the IADPSG criteria. Different diagnostic criteria could lead to different GDM detection rates with different practical approaches. Full article
(This article belongs to the Special Issue Screening and Diagnosis of Gestational Diabetes Mellitus)
11 pages, 861 KiB  
Article
Evolution of Mitochondrially Derived Peptides Humanin and MOTSc, and Changes in Insulin Sensitivity during Early Gestation in Women with and without Gestational Diabetes
by David Ruiz, Miguel Santibañez, Bernardo Alio Lavín, Ana Berja, Coral Montalban and Luis Alberto Vazquez
J. Clin. Med. 2022, 11(11), 3003; https://doi.org/10.3390/jcm11113003 - 26 May 2022
Cited by 4 | Viewed by 1756
Abstract
Our purpose is to study the evolution of mitochondrially derived peptides (MDPs) and their relationship with changes in insulin sensitivity from the early stages of pregnancy in a cohort of pregnant women with and without gestational diabetes (GDM). MDPs (humanin and MOTSc) were [...] Read more.
Our purpose is to study the evolution of mitochondrially derived peptides (MDPs) and their relationship with changes in insulin sensitivity from the early stages of pregnancy in a cohort of pregnant women with and without gestational diabetes (GDM). MDPs (humanin and MOTSc) were assessed in the first and second trimesters of gestation in 28 pregnant women with gestational diabetes mellitus (GDM) and a subgroup of 45 pregnant women without GDM matched by BMI, age, previous gestations, and time of sampling. Insulin resistance (IR) was defined as a HOMA-IR index ≥70th percentile. We observed a significant reduction in both humanin and MOTSc levels from the first to the second trimesters of pregnancy. After adjusting for predefined variables, including BMI, statistically nonsignificant associations between lower levels of humanin and the occurrence of a high HOMA-IR index were obtained (adjusted OR = 2.63 and 3.14 for the first and second trimesters, linear p-trend 0.260 and 0.175, respectively). Regarding MOTSc, an association was found only for the second trimester: adjusted OR = 7.68 (95% CI 1.49–39.67), linear p-trend = 0.012. No significant associations were observed in humanin change with insulin resistance throughout pregnancy, but changes in MOTSc levels were significantly associated with HOMA-IR index: adjusted OR 3.73 (95% CI 1.03–13.50). In conclusion, MOTSc levels, especially a strong decrease from the first to second trimester of gestation, may be involved in increasing insulin resistance during early gestation. Full article
(This article belongs to the Special Issue Screening and Diagnosis of Gestational Diabetes Mellitus)
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11 pages, 1506 KiB  
Article
Adiponectin, A-FABP and FGF-19 Levels in Women with Early Diagnosed Gestational Diabetes
by David Karasek, Ondrej Krystynik, Veronika Kucerova, Dominika Macakova, Lubica Cibickova, Jan Schovanek and Martin Haluzik
J. Clin. Med. 2022, 11(9), 2417; https://doi.org/10.3390/jcm11092417 - 25 Apr 2022
Cited by 3 | Viewed by 1558
Abstract
Background: Adiponectin, adipocyte fatty acid-binding protein (A-FABP), and fibroblast growth factor-19 (FGF-19) belong to proteins involved in glucose metabolism regulation. The aims of the study were to compare the plasma levels of these proteins in women with early diagnosed gestational diabetes mellitus (GDM) [...] Read more.
Background: Adiponectin, adipocyte fatty acid-binding protein (A-FABP), and fibroblast growth factor-19 (FGF-19) belong to proteins involved in glucose metabolism regulation. The aims of the study were to compare the plasma levels of these proteins in women with early diagnosed gestational diabetes mellitus (GDM) to those in healthy controls and to investigate their changes during pregnancy after early intervention. Methods: The study was undertaken as a case-control study. Early GDM diagnosis was based on repeated fasting plasma glucose ≥5.1 and <7.0 mmol/L during the first trimester of pregnancy and exclusion of overt diabetes. Age-matched controls comprised healthy pregnant and non-pregnant women. In addition to adipokines, clinical parameters and measures of glucose control were assessed. Results: Women with GDM (n = 23) had significantly lower adiponectin and higher A-FABP levels compared to healthy pregnant (n = 29) or non-pregnant (n = 25) controls, while no significant differences in FGF-19 between the groups were found. The therapeutic intervention shifted adiponectin and A-FABP levels in GDM women towards concentrations of healthy pregnant controls. Adipokines were associated with visceral adiposity and glucose control. Conclusion: Women with GDM showed altered adipokine production even in the first trimester of pregnancy. Early therapeutic intervention not only improved glucose control but also normalized impaired adipokine production. Full article
(This article belongs to the Special Issue Screening and Diagnosis of Gestational Diabetes Mellitus)
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12 pages, 550 KiB  
Article
Serum C18:1-Cer as a Potential Biomarker for Early Detection of Gestational Diabetes
by Ilona Juchnicka, Mariusz Kuźmicki, Piotr Zabielski, Adam Krętowski, Agnieszka Błachnio-Zabielska and Jacek Szamatowicz
J. Clin. Med. 2022, 11(2), 384; https://doi.org/10.3390/jcm11020384 - 13 Jan 2022
Cited by 10 | Viewed by 2160
Abstract
We hypothesized that sphingolipids may be early biomarkers of gestational diabetes mellitus (GDM). Here, 520 women with normal fasting plasma glucose levels were recruited in the first trimester and tested with a 75 g oral glucose tolerance test in the 24th–28th week of [...] Read more.
We hypothesized that sphingolipids may be early biomarkers of gestational diabetes mellitus (GDM). Here, 520 women with normal fasting plasma glucose levels were recruited in the first trimester and tested with a 75 g oral glucose tolerance test in the 24th–28th week of pregnancy. Serum sphingolipids concentrations were measured in the first and the second trimester by ultra-high performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC/MS/MS) in 53 patients who were diagnosed with GDM, as well as 82 pregnant women with normal glucose tolerance (NGT) and 32 non-pregnant women. In the first trimester, pregnant women showed higher concentrations of C16:0, C18:1, C22:0, C24:1, and C24:0-Cer and lower levels of sphinganine (SPA) and sphingosine-1-phosphate (S1P) compared to non-pregnant women. During pregnancy, we observed significant changes in C16:0, C18:0, C18:1, and C24:1-Cer levels in the GDM group and C18:1 and C24:0-Cer in NGT. The GDM (pre-conversion) and NGT groups in the first trimester differed solely in the levels of C18:1-Cer (AUC = 0.702 p = 0.008), also considering glycemia. Thus, C18:1-Cer revealed its potential as a GDM biomarker. Sphingolipids are known to be a modulator of insulin resistance, and our results indicate that ceramide measurements in early pregnancy may help with GDM screening. Full article
(This article belongs to the Special Issue Screening and Diagnosis of Gestational Diabetes Mellitus)
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13 pages, 1008 KiB  
Article
Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy
by Emmanuel Cosson, Sid Ahmed Bentounes, Charlotte Nachtergaele, Narimane Berkane, Sara Pinto, Meriem Sal, Hélène Bihan, Sopio Tatulashvili, Jean-Jacques Portal, Lionel Carbillon and Eric Vicaut
J. Clin. Med. 2021, 10(17), 3904; https://doi.org/10.3390/jcm10173904 - 30 Aug 2021
Cited by 9 | Viewed by 1854
Abstract
We aimed to compare pregnancy outcomes in 4665 women according to the following types of hyperglycaemia in pregnancy sub-types: (i) normoglycaemia, (ii) gestational diabetes mellitus (GDM), (iii) diabetes in pregnancy (DIP), (iv) early-diagnosed (i.e., <22 weeks of gestation) GDM (eGDM), and (v) early-diagnosed [...] Read more.
We aimed to compare pregnancy outcomes in 4665 women according to the following types of hyperglycaemia in pregnancy sub-types: (i) normoglycaemia, (ii) gestational diabetes mellitus (GDM), (iii) diabetes in pregnancy (DIP), (iv) early-diagnosed (i.e., <22 weeks of gestation) GDM (eGDM), and (v) early-diagnosed DIP (eDIP). The prevalence of normoglycaemia, eGDM, eDIP, GDM, and DIP was 76.4%, 10.8%, 0.6%, 11.7%, and 0.6%, respectively. With regard to pregnancy outcomes, gestational weight gain (11.5 ± 5.5, 9.0 ± 5.4, 8.3 ± 4.7, 10.4 ± 5.3, and 10.1 ± 5.0 kg, p < 0.0001) and insulin requirement (none, 46.0%, 88.5%, 25.5%, and 51.7%; p < 0.001) differed according to the glycaemic sub-types. eGDM and eDIP were associated with higher rates of infant malformation. After adjustment for confounders, with normoglycaemia as the reference, only GDM was associated with large-for-gestational-age infant (odds ratio 1.34 (95% interval confidence 1.01–1.78) and only DIP was associated with hypertensive disorders (OR 3.48 (1.26–9.57)). To conclude, early-diagnosed hyperglycaemia was associated with an increased risk of malformation, suggesting that it was sometimes present at conception. Women with GDM, but not those with eGDM, had an increased risk of having a large-for-gestational-age infant, possibly because those with eGDM were treated early and therefore had less gestational weight gain. Women with DIP might benefit from specific surveillance for hypertensive disorders. Full article
(This article belongs to the Special Issue Screening and Diagnosis of Gestational Diabetes Mellitus)
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