Gestational Diabetes Mellitus: NICE for the U.S.?: A comparison of the American Diabetes Association and the American College of Obstetricians and Gynecologists guidelines with the U.K. National Institute for Health and Clinical Excellence guidelines

OBJECTIVE - To compare recent U.S. and U.K. guidelines on gestational diabetes mellitus (GDM)

High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: In-house study and systematic review

Background: High iron measured using dietary and serum biomarkers have been associated with type 2 diabetes; however it is uncertain whether a similar association exists for gestational diabetes mellitus (GDM). Objectives: To conduct a cohort study examining first trimester body iron stores and subsequent risk of GDM and to include these findings in a systematic review of all studies examining the association between maternal iron status, iron intake (dietary and supplemental) and the risk of GDM. Methods: Serum samples for women with first trimester screening were linked to birth and hospital records for data on maternal characteristics and GDM diagnosis. Blood was analysed for ferritin, soluble transferrin receptor (sTfR) and C-reactive protein (CRP). Associations between iron biomarkers and GDM were assessed using multivariate logistic regression. A systematic review and meta-analysis, registered with PROSPERO (CRD42014013663) included all studies published in English from Jan 1995 to March 2014 that examined the association between iron and GDM and included an appropriate comparison group. Results: Of 3, 776 women, 3.4% subsequently developed GDM. Adjusted analyses found increased odds of GDM for ferritin (OR 1.41; 95% CI: 1.11, 1.78) but not for sTfR (OR 1.00, 95% CI: 0.97, 1.03) levels. Two trials of iron supplementation in early pregnancy found no association with GDM. Increased risk of GDM was associated with higher levels of maternal ferritin and serum iron and dietary heme iron intakes. Conclusions: Increased risk of GDM among women with high serum ferritin and iron levels and dietary heme iron intakes warrants further investigation.NHMR

Gestational diabetes

Gestational diabetes is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The actual glucose thresholds used to define gestational diabetes vary greatly between different countries although the recent Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study (see page 32) may lead to a consensus on the diagnostic criteria

Gestational diabetes mellitus : NICE for the U.S.? : a comparison of the American Diabetes Association and the American College of Obstetricians and Gynecologists Guidelines with the U.K. National Institute for Health and Clinical Excellence Guidelines : response to Holt et al.

Response to: Holt RIG, Jacklin PB, Round JA, Mugglestone MA, Hughes RG. Gestational diabetes mellitus: NICE for the U.S.? A comparison of the American Diabetes Association and the American College of Obstetricians and Gynecologists guidelines with the U.K. National Institute for Health and Clinical Excellence guidelines: response to Simmons et al. (Letter). Diabetes Care 2010; 33:e46. DOI: 10.2337/dc09-223