How many Danish women should be screened for gestational diabetes? Cathrine Scheuer’s PhD project – supported by the Danish Diabetes Academy to the tune of DKK 1.1 million – may prove to be key to the decision.

In Denmark, gestational diabetes testing is only offered to pregnant women with risk factors for type 2 diabetes. However, in 2013  the WHO issued new guidelines on testing and diagnosis of gestational diabetes which recommended: 1) that all pregnant women should be offered testing; and 2) that women with blood sugar below the threshold currently used in Denmark should also be diagnosed as having gestational diabetes.

If the WHO recommendations are introduced in Denmark, it will mean the gestational diabetes test being offered to 60,000 pregnant women per year, while a Danish study has estimated that, with the WHO’s diagnostic threshold, up to 40% of pregnant Danish women will receive the diagnosis - as against approximately 4% at present, says Cathrine Scheuer.

However, much remains unknown about what will happen if the WHO recommendations are introduced, including:

1. exactly how much the incidence of gestational diabetes will go up by in Denmark;
2. whether there will be a health benefit for the women (and their babies) diagnosed according to the WHO’s recommendations as compared with the Danish diagnostic guidelines; and
3. what the financial and logistical implications will be for the Danish health service.

‘Our study will look into the health-related and financial pros and cons if the WHO recommendations are introduced in Denmark. The results of the study will thus provide the knowledge required to take an evidence-based decision on the future management of gestational diabetes in Denmark. The aim is to use the results to find a structured screening and diagnosis model for gestational diabetes that medicalizes as few people as possible while providing the greatest possible health benefit within a realistic financial framework’, says Cathrine Scheuer.  

FACTS
Gestational diabetes is typically diagnosed at the end of the second trimester and is caused by the mother’s impaired ability to metabolize sugar in the blood. Left untreated, the mother’s raised blood sugar will also affect the foetus’s sugar metabolism. Babies born to mothers with gestational diabetes are therefore often bigger than those of healthy mothers, and both mother and baby have a markedly higher risk of developing excess weight and type 2 diabetes later in life.

CONTACT

Cathrine Scheuer MD,
Faculty of Health and Medical Sciences, University of Copenhagen

catrold@gmail.com

+45 61711032

‘The aim is to use the results to find a structured screening and diagnosis model for gestational diabetes that medicalizes as few people as possible while providing the greatest possible health benefit within a realistic financial framework.’