[Screening for gestational diabetes in Bulgaria--preliminary results]

Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance with onset or first recognition during pregnancy. There is no data regarding the prevalence of GDM in Bulgaria. The aim of this study is to present the preliminary results from a pilot study for GDM in Bulgaria, including the prevalence and the epidemiological differences between women with or without this disorder. A 2 h oral glucose tolerance test (OGTT) with 75g glucose was performed on 330 pregnant women between 24 and 28 weeks of gestation, using ADA criteria to define pregnancies complicated by GDM. Blood glucose levels, insulin levels, HbA1c, hsCRP and lipid parameters were evaluated. GDM was found in 11.3% of the patients. Women with GDM were older than the ones without the disorder (p < 0.006), had higher fasting glucose levels (p < 0.0001), higher fasting insulin levels (p < 0.0001), higher HOMA index (p < 0.0001) and higher HbA1c (p < 0.001). There was a significant difference in body mass index (BMI) before pregnancy (p < 0.003) and at the time of screening (p < 0.001) between GDM and control groups (p < 0.001). GDM women more frequently had thyroid disease, developed early preeclampsia, had family history of type 2 diabetes mellitus and history of PCOS. In conclusion the prevalence of GDM in high risk Bulgarian population is relatively high--11.3%. This confirms the necessity of establishing of a national screening program. If financial recourses are limited selective screening in high risk patients should be considered.