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Clinical Outcomes Following a Change in Gestational Diabetes Mellitus Diagnostic Criteria Due to the COVID-19

Niamh Keating1, Kirsten Carpenter2, Kelsey McCarthy2

  • 1UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, 4 Dublin, Ireland.

International Journal of Environmental Research and Public Health
|February 15, 2022
PubMed

Insights

The COVID-19 pandemic led to fewer gestational diabetes mellitus (GDM) diagnoses, but higher-risk pregnancies were still identified. The glucose tolerance test (GTT) remains the gold standard for GDM diagnosis.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • The COVID-19 pandemic prompted changes in gestational diabetes mellitus (GDM) diagnostic practices in many healthcare centers.
  • Altered diagnostic criteria and testing protocols may have impacted GDM detection rates and management.

Purpose of the Study:

  • To evaluate the impact of COVID-19 related changes on GDM diagnosis and outcomes.
  • To compare GDM detection rates, medication use, and obstetric/fetal outcomes between pre-pandemic and pandemic periods.

Main Methods:

  • A case-control study design was employed.
  • Antenatal patients from April 1 to June 30 in 2019 and 2020 were analyzed.
  • Key metrics included GDM detection rates, medication requirements (insulin, metformin), and birth outcomes.

Main Results:

  • GDM diagnosis rates significantly decreased during the COVID-19 period (20% in 2020 vs. 42.2% in 2019).
  • There was a notable increase in the need for insulin and metformin at diagnosis and term among diagnosed GDM patients in 2020.
  • Despite changes in diagnosis and medication, no significant differences in obstetric or fetal outcomes were observed between the two periods.

Conclusions:

  • The study suggests a potential underdiagnosis of GDM during the COVID-19 pandemic, although high-risk pregnancies were likely still identified.
  • The glucose tolerance test (GTT) is recommended as the gold-standard for GDM diagnosis, with adaptations for social distancing if necessary.
Abstract

Keywords:
COVID-19antenatal caregestational diabetes mellitus

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