Volume 202 - Issue 3
Reassessment of the new diagnostic thresholds for gestational diabetes mellitus: an opportunity for improvement
Authors: Anna S Y Zheng, Tony O’Leary and Robert G Moses
Med J Aust 2015; 202 (3): 133. || doi: 10.5694/mja14.01492
Published online: 16 February 2015
Published online: 16 February 2015
New criteria will increase the prevalence of gestational diabetes but will improve obstetric outcomes
To the Editor: A recent article by d'Emden focused on concerns about the new diagnostic criteria for gestational diabetes mellitus (GDM).1 In his article, he states that “women may be charged higher life insurance premiums because of a prior diagnosis of GDM”.1 A similar unreferenced concern was also expressed in 2013.2
We specifically examined this aspect in an Australian context.3 Twelve life insurance companies, responsible for more than an estimated 90% of the Australian retail life insurance market, were surveyed with a request from a hypothetical applicant. This applicant was a 40-year-old woman, with no current health problems, who had an episode of GDM 10 years earlier and a subsequent normal result on an oral glucose tolerance test. Ten of the twelve companies (83%) responded, and were unanimous that no additional insurance premium would be required.
The new Australasian Diabetes in Pregnancy Society criteria are likely to result in an increased prevalence of GDM.4 Logically, this may lead to an increase in the cost of initial treatment, but this cost may effectively be recovered by better obstetric outcomes.5 Local data are required.
It is inevitable that any change will be accompanied by differences of opinion. Whenever possible, these opinions should not be alarmist.
Competing interests
No relevant disclosures.
References
- d'Emden MC. Reassessment of the new diagnostic thresholds for gestational diabetes mellitus: an opportunity for improvement. Med J Aust 2014; 201: 209-211. _Ref410313626
- Ryan EA. Balancing weight and glucose in gestational diabetes mellitus. Diabetes Care 2013; 36: 6-7. _Ref410313629
- Zheng ASY, O'Leary T, Moses RG. Gestational diabetes mellitus and life insurance: what is the impact of gestational diabetes mellitus on life insurance premiums? Diabetes Care 2014; 37: e235. _Ref410313631
- Moses RG, Morris GJ, Petocz P, et al. The impact of potential new diagnostic criteria on the prevalence of gestational diabetes mellitus in Australia. Med J Aust 2011; 197: 338-340. _Ref410313633
- Duran A, Sáenz S, Torrejón MJ, et al. Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St Carlos Gestational Diabetes Study. Diabetes Care 2014; 37: 2442-2450. _Ref410313637