GESTATIONAL DIABETES IN THE MEDITERRANEAN REGION
The Mediterranean area represents a unique regional example of the interplay of varying ethnicities and socio-economic differences. The region can be regarded as a single unit with a large number of common ethnic and cultural features and heterogeneous in terms of socio-economic and demographical factors. Thus, most of the Northern Mediterranean countries (European coast) share the features of other industrialized countries, while most of the Southern Mediterranean (African coast) belongs to the developing world. The Mediterranean islands and Eastern countries (Asian coast) share a mixture of these features. In the Mediterranean region, the prevalence of Type 2 diabetes mellitus (DM) varies widely. It appeared to be a Type 2 DM prevalence relationship with population density of the country and degree of urbanization.
The relative high prevalence of Type 2 DM should be reflected as similar elevated prevalence of Gestational DM (GDM), since the pregnant state brings out to the front any underlying insulin resistance. This higher prevalence of insulin resistance, often still compensated for during the reproductive age, is reflected by a relatively high prevalence of GDM. Epidemiological studies have shown that the prevalence of GDM in the Maltese pregnant population approximates 5.9%. There is a further 0.3% of the population who suffer from a pre-existing form of diabetes.
The adoption of the IADPSG proposal for GDM diagnosis relying on a single-value blood glucose cut-off criterion will significantly increase the number of cases of diagnosed GDM. The present recommendations for screening for the presence of GDM are based on the use of universal biochemical screening using a 75-g oral GT test (oGTT). This has economic consequences that may stress health service provisions in particular regions.