Heterogeneity of glycometabolism in patients with gestational diabetes mellitus: Retrospective study of 1,683 pregnant women.

AIMS/INTRODUCTION: To evaluate the glycometabolism and outcomes of gestational diabetes mellitus (GDM) patients according to the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in China.

MATERIALS AND METHODS: According to the results of a 75-g oral glucose tolerance test, 1,683 pregnant women were divided into three groups: (i) an increment GDM group (patients meet the IADPSG criteria, but not the previous Chinese criteria); (ii) a stock GDM group (patients meet both criteria); and (iii) a normal glucose tolerance group. Their glycometabolism outcomes, prepregnancy and postpartum body mass index were compared, as were maternal-fetal outcomes.

RESULTS: The IADPSG and previous Chinese criteria diagnosed 12.4% and 5.5% of women with GDM. Pairwise comparison showed significant differences in 1-h plasma glucose, 2-h plasma glucose, HbA1c values and area under curve of glucose among all groups (P < 0.01). The fasting plasma glucose and postpartum body mass index of the stock group were significantly higher than those of the other two groups (P < 0.01). The incidences of hypertensive disorder complicating pregnancy and cesarean section of the normal glucose tolerance group were significantly lower than those of the other two groups (P < 0.001). No significant differences in patient age, prepregnancy body mass index, duration of pregnancy, prevalence of premature labor, premature rupture of membranes, neonatal jaundice, neonatal asphyxia or Ponderal Index were observed, but significant differences in macrosomia and neonatal hypoglycemia were observed (P < 0.05).

CONCLUSIONS: The IADPSG criteria doubled the number of GDM patients. The cases of the increment patients were mild. The IADPSG criteria should be discussed fully before implementation in China.