TY  - BOOK
AU  - Miodovnik, Menachem
AU  - Umans, Jason G
TI  - Perspectives on the proposed gestational diabetes  mellitus diagnostic criteria
SN  - 0029-7844
PY  - 2013///
KW  - *Diabetes, Gestational/di [Diagnosis]
KW  - *Practice Guidelines as Topic
KW  - Blood Glucose/an [Analysis]
KW  - Diabetes, Gestational/ec [Economics]
KW  - Female
KW  - Glucose Tolerance Test
KW  - Humans
KW  - Pregnancy Outcome/ec [Economics]
KW  - Pregnancy Outcome/ep [Epidemiology]
KW  - Pregnancy
KW  - Prevalence
KW  - MedStar Health Research Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 -  present, Available in print through MWHC library: 1999 -  2006
N2  - To date, The International Association of the  Diabetes and Pregnancy Study Groups (IADPSG) criteria for  the diagnosis of gestational diabetes mellitus (GDM) have  not been analyzed systematically for medical, social, and  economic ramifications if used in substitution for the  current GDM diagnostic criteria. The IADPSG dependence on  expert opinion and consensus rather than on rigorously  obtained outcome measures is concerning given the dramatic  changes in clinical intervention and medical-resource  reallocation that would follow their wide adoption. This  commentary attempts to highlight needed research as well as  the key knowledge gaps that should prevent adoption of the  revised criteria until their effect on perinatal outcomes  and health care costs is determined. In light of the  overall, ethnic, and regional variation in GDM prevalence  and the demands of increased GDM diagnosis on clinical  resources, it may not be realistic and practical to impose  universal strategies and standards for diagnosis. The newly  proposed criteria may affect medical care negatively,  unnecessarily stigmatize patients with a "sick label," and  adversely affect health care costs without ensuring the  desired improvements in maternal and neonatal outcomes. This  commentary serves as a caution to not promote a new endeavor  until it has been compared rigorously with current practice  and its implications are understood fully
UR  - http://dx.doi.org/10.1097/AOG.0b013e31827711e5
ER  -