Implementation of new recommendations for the diagnosis of gestational diabetes (GDM): a five month audit
Poster
Data di Pubblicazione:
2011
Citazione:
Implementation of new recommendations for the diagnosis of gestational diabetes (GDM): a five month audit / D. Szoke, C. Valente, A. Dolci, M. Panteghini. - In: CLINICAL CHEMISTRY AND LABORATORY MEDICINE. - ISSN 1434-6621. - 49:Suppl. 1(2011), pp. S371-S371. ((Intervento presentato al 19. convegno IFCC - WordLab - EuroMedLab tenutosi a Berlin nel 2011 [10.1515/CCLM.2011.510].
Abstract:
Background. Early diagnosis of GDM has an important role to prevent adverse outcomes. Recent international recommendations, according to the HAPO study and IADPSG Consensus Panel (Diabetes Care 2010;33:676), were implemented in our university hospital. After five months, we aimed to audit the impact and the appropriateness of use of the new diagnostic approach.
Methods. Two five-month (June-October) periods, one before [2009, using the two OGTTs standard approach (S1)] and one after the implementation of the new criteria [2010, (S2)], were compared.
Results. In the two periods, 256 (S1) and 245 (S2) pregnant women were examined. 298 OGTTs (50g, n=195; 100g, n=103) and 252 OGTTs (75g) were executed in S1 and S2, respectively. In S1, 54 (27.7%) 50gOGTTs resulted positive and 36 (66.7%) of those performed the 100gOGTT. In addition, 3 (1.5% of total) 50gOGTT negative women were submitted to 100gOGTT. 63 women did 100gOGTT only. In total, 14 (13.6%) 100gOGTTs were positive. In S2, 38 (15.1%) OGTTs resulted positive. In women who did the whole diagnostic evaluation in our hospital, 92.3% in S1 and 77.0% in S2 performed the correct protocol. The rate of incomplete OGTTs was low (0.7% in S1 and 2.4% in S2). Conclusions. Our data show that in our hospital new recommendations for GDM diagnosis are not correctly applied in about ¼ of cases. The main issue seems to be the lack of consideration of the new threshold of fasting glycemia (92 mg/dL) as main decisional driver for performing OGTT. Further education of ordering physicians is advisable.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
D. Szoke, C. Valente, A. Dolci, M. Panteghini
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