STUDY OF GESTATIONAL DIABETES IN THE MEDITERRANEAN REGION
JUSTIFICATION AND OBJECTIVES
PROF. SANTIAGO DURAN GARCIA. Professor of Endocrinology. Faculty of Medicine. University of Seville. Past-President of the Mediterranean Group for the Study of Diabetes (MGSD)
In the MGSD meeting held in Marrakech in 2000, we reviewed the consequences of applying the diagnostic criteria of Carpenter and Coustan published in 1998, compared to the classical NDDG criteria, in the Spanish population of patients with gestational diabetes (gestational diabetes: consequences of the application of the 1998 criteria; MGSD congress, Marrakech, 2000). In our experience, we concluded that the prevalence of gestational diabetes was similar using either of the diagnostic criteria, as was the proportion of patients that were reclassified as diabetes mellitus or glucose intolerant in the post-partum control.
In the wake of the publication of the HAPO study, a re-evaluation of the previous results on the prevalence of gestational diabetes is necessary in all countries. Hence the importance of the study sponsored by the MGSD that intends to update the prevalence of gestational diabetes in Mediterranean countries. It will not only provide better knowledge of the real magnitude of this important clinical problem, but will also attempt to evaluate the relation to perinatal complications and to the development of glucose tolerance immediately after post-partum. The importance of the eating habits of the population under study and their possible relation to the appearance of gestational diabetes is another aspect that is being considered in the MGSD study. Unfortunately it has not been possible to include in the study all the countries that were initially expected to take part. For various reasons, such representative countries as Turkey and Spain have been excluded. In the case of Spain, this was due to the unwillingness of obstetricians to modify diagnostic protocols based on the O’Sullivan test and on the 100-g glucose tolerance test. Despite these absences, close to 1400 pregnant women, who consented to be subjected to the protocol, were recruited by the whole MGSD board in the wake of the initiative arising from the “Diabetes and the Mediterranean diet” workshop that was held in Paris on 2 March, 2007.