J Trujillo1, A Vigo2, A Reichelt3, B B Duncan2, M I Schmidt2. 1. Post Graduate Studies Program in Epidemiology, School of Medicine, Rio Grande do Sul Federal University, Rua Ramiro Barcelos 2600, sala 414, 90035-003, Porto Alegre, RS, Brazil. Electronic address: njtrujill@gmail.com. 2. Post Graduate Studies Program in Epidemiology, School of Medicine, Rio Grande do Sul Federal University, Rua Ramiro Barcelos 2600, sala 414, 90035-003, Porto Alegre, RS, Brazil. 3. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Abstract
AIMS: To evaluate the performance of fasting plasma glucose (FPG) in determining the need for a full oral glucose tolerance test (OGTT) to diagnose gestational diabetes (GDM) by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. METHODS: A multicenter cohort study of 4926 pregnant women 20 years or older consecutively enrolled in prenatal care clinics of the Brazilian National Health Service from 1991 to 1995. All women underwent a single 2 h 75 g OGTT by weeks 24-28 of pregnancy and were followed to detect adverse pregnancy outcomes. RESULTS: A FPG cut-off value of 80 mg/dl indicated that only 38.7% of all women needed to undergo a complete OGTT, while detecting 96.9% of all GDM cases. When the 85 mg/dl cut-off was used, the corresponding percentages were 18.7% and 92.5%, respectively. The fraction of women labeled with GDM who had adverse pregnancy outcomes was nearly identical when using FPG strategies and universal full testing. CONCLUSIONS: Using a FPG cut-off to diagnose GDM and to determine the need for post-load OGTT measurements is a valid strategy to diagnose GDM by IADPSG criteria. This approach may improve feasibility of applying IADPSG diagnostic criteria by reducing costs and increasing convenience.
AIMS: To evaluate the performance of fasting plasma glucose (FPG) in determining the need for a full oral glucose tolerance test (OGTT) to diagnose gestational diabetes (GDM) by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. METHODS: A multicenter cohort study of 4926 pregnant women 20 years or older consecutively enrolled in prenatal care clinics of the Brazilian National Health Service from 1991 to 1995. All women underwent a single 2 h 75 g OGTT by weeks 24-28 of pregnancy and were followed to detect adverse pregnancy outcomes. RESULTS: A FPG cut-off value of 80 mg/dl indicated that only 38.7% of all women needed to undergo a complete OGTT, while detecting 96.9% of all GDM cases. When the 85 mg/dl cut-off was used, the corresponding percentages were 18.7% and 92.5%, respectively. The fraction of women labeled with GDM who had adverse pregnancy outcomes was nearly identical when using FPG strategies and universal full testing. CONCLUSIONS: Using a FPG cut-off to diagnose GDM and to determine the need for post-load OGTT measurements is a valid strategy to diagnose GDM by IADPSG criteria. This approach may improve feasibility of applying IADPSG diagnostic criteria by reducing costs and increasing convenience.
Authors: Jee Soo Park; Deok Won Kim; Ja-Young Kwon; Yong Won Park; Young Han Kim; Hee Young Cho Journal: Medicine (Baltimore) Date: 2016-01 Impact factor: 1.817