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Diagnosis of Gestational Diabetes Mellitus: Italian Perspectives on Risk Factor-Based Screening

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Nutrition and Diet in Maternal Diabetes

Part of the book series: Nutrition and Health ((NH))

Abstract

First a short review of the history of gestational diabetes mellitus (GDM) screening and diagnosis procedures has been reported. Afterwards, studies involving Italian population on this topic are discussed. Current GDM prevalence according to the risk factor-based screening proposed by the Italian National Institute of Health is 11%. However, there are limits to the risk factors selection and it is argued that they are not all capable of correctly predicting GDM onset. The utility of an alternative screening approach, based on risk stratification derived from the application of tree-growing regression techniques, is proposed. Sensitivity and specificity of this kind of procedure are discussed, highlighting that it is not able to diagnose all the GDM cases but it is able to identify the majority of them saving economic resources. Finally, results of a recent national survey on the degree of diffusion and healthcare professionals acceptance of the Italian guideline has been reported and discussed. The survey allowed to recognize some criticisms, mainly linked to the choice of universal or risk factor-based screening and to the correct timing for executing the diagnostic test in women at high risk for GDM. Stakeholders should reconsider risk factors for GDM if a selective screening approach would be continued. Risk models based on epidemiological data and population-based cohorts could represent future perspectives for the solution of the dilemma of finding the best screening procedure for GDM.

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Abbreviations

GDM:

Gestational diabetes mellitus

NICU:

Neonatal intensive care unit

GCT:

Glucose challenge test

NDDG:

National Diabetes Data Group

ADA:

American Diabetes Association

HAPO:

Hyperglycemia and adverse pregnancy outcomes

IADPSG:

International Association Of Diabetes In Pregnancy Study Group

RECPAM:

RECursive Partitioning and AMalgamation

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Acknowledgements

D’Amico Angela, MD, for a critical reading of the whole manuscript and the grammar and English corrections.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, A.O.U. Policlinico “G. Martino”, Policlinico Universitario, University of Messina, Via Consolare Valeria, 1, Messina, Italy

    Francesco Corrado

  2. Diabetic Unit, Niguarda Cà Granda, A.O. Ca’ Granda Niguarda, Piazza Ospedale Maggiore 3, Milano, Italy

    Basilio Pintaudi

Authors
  1. Francesco Corrado
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  2. Basilio Pintaudi
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Corresponding author

Correspondence to Francesco Corrado .

Editor information

Editors and Affiliations

  1. Department of Nutrition, King’s College London, London, United Kingdom

    Rajkumar Rajendram

  2. Department of Nutrition, King’s College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Corrado, F., Pintaudi, B. (2018). Diagnosis of Gestational Diabetes Mellitus: Italian Perspectives on Risk Factor-Based Screening. In: Rajendram, R., Preedy, V., Patel, V. (eds) Nutrition and Diet in Maternal Diabetes. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-56440-1_9

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  • DOI: https://doi.org/10.1007/978-3-319-56440-1_9

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-56438-8

  • Online ISBN: 978-3-319-56440-1

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