H Fadl1, I Ostlund, K Nilsson, U Hanson. 1. Department of Obstetrics and Gynaecology, Orebro University Hospital, Sweden. helena.fadl@orebroll.se
Abstract
OBJECTIVE: To evaluate fasting capillary glucose as a screening test for gestational diabetes mellitus (GDM) compared with traditional risk factors and repeated random capillary glucose measurements. DESIGN: Cross-sectional, population-based study. SETTING: Maternal Health Care Clinics in Orebro County, Sweden. POPULATION: An unselected population of women without diabetes. METHODS: Fasting capillary glucose levels were measured at gestational weeks 28-32. Random capillary glucose levels were measured four to six times during pregnancy. Traditional risk factors for GDM were registered. GDM was diagnosed using a 75-g oral glucose tolerance test. MAIN OUTCOME MEASURES: Sensitivity, specificity, likelihood ratios. RESULTS: In 55 of 3616 women participating in the study, GDM was diagnosed before 34 weeks of gestation. For fasting capillary glucose cutoff values between 4.0 and 5.0 mmol/l, sensitivity was in the range between 87 and 47% and specificity between 51 and 96%. Using a combined screening model of traditional risk factors with fasting capillary glucose at various cutoff values increased the sensitivity only slightly compared with using fasting capillary glucose alone. CONCLUSION: In this Swedish, unselected, low-risk population, fasting capillary glucose measurements were found to be an acceptable and useful screening test for GDM.
OBJECTIVE: To evaluate fasting capillary glucose as a screening test for gestational diabetes mellitus (GDM) compared with traditional risk factors and repeated random capillary glucose measurements. DESIGN: Cross-sectional, population-based study. SETTING: Maternal Health Care Clinics in Orebro County, Sweden. POPULATION: An unselected population of women without diabetes. METHODS: Fasting capillary glucose levels were measured at gestational weeks 28-32. Random capillary glucose levels were measured four to six times during pregnancy. Traditional risk factors for GDM were registered. GDM was diagnosed using a 75-g oral glucose tolerance test. MAIN OUTCOME MEASURES: Sensitivity, specificity, likelihood ratios. RESULTS: In 55 of 3616 women participating in the study, GDM was diagnosed before 34 weeks of gestation. For fasting capillary glucose cutoff values between 4.0 and 5.0 mmol/l, sensitivity was in the range between 87 and 47% and specificity between 51 and 96%. Using a combined screening model of traditional risk factors with fasting capillary glucose at various cutoff values increased the sensitivity only slightly compared with using fasting capillary glucose alone. CONCLUSION: In this Swedish, unselected, low-risk population, fasting capillary glucose measurements were found to be an acceptable and useful screening test for GDM.