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Eur J Obstet Gynecol Reprod Biol. 2004 Apr 15;113(2):149-53.

Gestational diabetes: implications of variation in post-partum follow-up criteria.

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Department of Pathology, Faculty of Medicine, UAE University, PO Box 17666, Al Ain, United Arab Emirates.



To compare the recommendations of the American Diabetes Association (ADA) with the World Health Organization (WHO) for evaluating women with gestational diabetes (GDM) after delivery.


During a 5-year period, 549 patients underwent the 2h, 75 g oral glucose tolerance test (OGTT), 4-8 weeks after delivery. They were classified by the criteria of WHO (1985), the ADA [1997, fasting glucose (FPG)] and the revised WHO (1999).


The prevalence of diabetes by WHO-1985 and ADA-1997 were similar (8.2% versus 6.6%) but estimates of impaired glucose homeostasis varied widely (15.5% impaired glucose tolerance (IGT) versus 9.3% impaired fasting glucose, respectively). 118 (21.5%) women and 83 (15.1%) women showed a classification discrepancy between ADA-1997 with the WHO-1985 and -1999, respectively. The receiver-operating characteristic (ROC) curve area of the FPG was 0.94 for DM by the OGTT (WHO-1985 criteria) but only 0.59 for IGT by the 2h post-glucose.


The various guidelines for GDM follow-up after delivery, often based on expert opinion, produce similar estimates for diabetes prevalence but widely discordant results for glucose intolerance. Until more uniform evidence-based criteria become available, the various strategies for GDM follow-up will continue to cause confusion in clinical practice.

[Indexed for MEDLINE]

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