Screening of GDM during COVID pandemic in an Italian setting: comparison between IADPSG and WHO '99 criteria

Background During pandemic period, a single fast glycemia value (>= 92 mg/dl) performed within the recommended time window for the risk level defined by the Italian guidelines, was considered an acceptable surrogate for GDM diagnosis following Italian Diabetes Association recomendations. Methods All pregnant women who performed an OGTT following Italian Guidelines from march 2020 to september 2021 and then delivered at our University Hospital were prospectively enrolled in this study. Primary outcome of the study was the number of women diagnosed with GDM with only the FPG value (>= 92 mg/dl), following Italian Diabetes Societies recommendations for COVID 19 pandemic period. At the same time, the data of women who became diabetic according to the 1999 WHO criteria was collected too. The secondary outcome was the comparison of risk factors of women undergoing OGTT according to IADPSG and WHO'99 criteria for the diagnosis of GDM and associated clinical outcomes. Results The number of women with a diagnosis of GDM following Italian guidelines in the 18-month period considered was 161. Only 109 (67.7%) had a fast glucose value >= 92 mg/dl. No differences between IADPSG and WHO'99 groups in relation to risk factors, with the exception for overweight and obesity, and clinical outcomes. Conclusion Recommendations of Italian Diabetes Societis for COVID 19 pandemic failed to recognize one third of GDM diagnosis.

Automated summary

This study prospectively enrolled all pregnant women who underwent OGTT according to Italian guidelines and delivered at the University Hospital from March 2020 to September 2021. The results showed that, according to the recommendations of the Italian Diabetes Association, some women were diagnosed with gestational diabetes mellitus based on the FPG value (>= 92 mg/dl), but still, one third were missed diagnosis.