Evaluatie van diagnostiek en behandeling bij diabetes gravidarum en identificatie van risicogroepen met een verhoogde kans op insulinetherapie.

Bergstra, J. (Jildou) (2016) Evaluatie van diagnostiek en behandeling bij diabetes gravidarum en identificatie van risicogroepen met een verhoogde kans op insulinetherapie. thesis, Medicine.

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Abstract

We conducted a retrospective case study. A total of 557 pregnant women were enrolled who underwent a 75-g OGTT in 2013. The purpose of this research is to identify whether there is overdiagnostics and/or overtreatment of pregnant women with the current protocol. The inquiry is whether you can restrict medicalization of pregnant women due to the 75 g-OGTT after two hours to increase the cut-off value from 7.8 mmol/l (current protocol) to 8.5 mmol/l (the new WHO criteria). The prevalence of gestational diabetes in this study population is 23,9% (133/557). When you apply the upper cut-off point, the diagnosis is made only in 12.6% (70/557). In that case, you save 11.3% (63/557) of the women supplementary examination and / or treatment. However, you deprive 14 women of insulin therapy. Untreated gestational diabetes increases the risk of perinatal complications. Based on the numbers it can be concluded that in this study population, given the increased risk of perinatal complications, medicalization of pregnant women cannot be reduced by using the higher cut-off point. The WHO also recommends a lower cut-off point for fasting plasma glucose levels. When you apply the two cut-off points (fasting and after two hours) according to the new WHO guideline is the prevalence of gestaional diabetes in this study population 25% (139/557). It can be concluded that in the MCL, no overdiagnostics and/or overtreatment can occur by following the new protocol. Secondary, an analysis was made into the factors that can predict the probability of insulin therapy. After regression analysis was discovered that a higher fasting plasma glucose level is predictive of the probability of insulin therapy.

Item Type:	Thesis (Thesis)
Supervisor name:	Facultair begeleider: and Spinder, Dr. T. and Locatie: Medisch Centrum Leeuwarden, afdeling gynaecologie e
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:58
Last Modified:	25 Jun 2020 10:58
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1850

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