Mervi Jokelainen1, Beata Stach-Lempinen2, Kristiina Rönö3, Arja Nenonen4, Hannu Kautiainen5, Kari Teramo6, Miira M Klemetti7. 1. Obstetrics and Gynaecology, South Karelia Central Hospital, Valto Käkelän katu 1, 53130 Lappeenranta, Finland; Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00029 HUS Helsinki, Finland. Electronic address: mervi.jokelainen@eksote.fi. 2. Obstetrics and Gynaecology, South Karelia Central Hospital, Valto Käkelän katu 1, 53130 Lappeenranta, Finland. Electronic address: beata.stach-lempinen@eksote.fi. 3. Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00029 HUS Helsinki, Finland. Electronic address: kristiina.rono@helsinki.fi. 4. Laboratory Center, South Karelia Central Hospital, Valto Käkelän katu 1, 53130 Lappeenranta, Finland. Electronic address: arja.nenonen@eksote.fi. 5. Folkhälsan Research Centre, Haartmaninkatu 8, 000290 Helsinki, Finland; Primary Health Care Unit, Kuopio University Hospital, P.O. Box 100, FI 70029 KYS Kuopio, Finland. Electronic address: hannu.kautiainen@medcare.fi. 6. Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00029 HUS Helsinki, Finland. Electronic address: kari.teramo@hus.fi. 7. Obstetrics and Gynaecology, South Karelia Central Hospital, Valto Käkelän katu 1, 53130 Lappeenranta, Finland; Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, 00029 HUS Helsinki, Finland; Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 8, 000290 Helsinki, Finland; Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 60 Murray Street, M5T 3L9 Toronto, Ontario, Canada. Electronic address: miira.klemetti@helsinki.fi.
Abstract
AIMS: To analyze early-pregnancy oral glucose tolerance test (OGTT) results and differences between early- and late-pregnancy OGTT results in a population-based cohort. METHODS: From 3/2013 to 12/2016, pregnant women in South Karelia, Finland, were invited to undergo a 2-hour 75 g OGTT at 12-16 weeks' gestation (OGTT1) and, if normal, repeat testing at 24-28 weeks (OGTT2). Early and late gestational diabetes (GDM) were diagnosed using the same nationally endorsed criteria (fasting [FPG], 1- or 2-hour plasma glucose ≥5.3, ≥10.0 or ≥8.6 mmol/L, respectively). RESULTS: In OGTT1 (n = 1401), the mean (SD) FPG, 1- and 2-hour values were 4.85 (0.34), 6.63 (1.73) and 5.60 (1.28) mmol/L, respectively. Early GDM was diagnosed in 209 (14.9%). In OGTT2 (n = 1067), late GDM was diagnosed in 114 (10.6%). In women without GDM (n = 953), the mean FPG values were higher and post-load values lower in OGTT1 vs. OGTT2. No interaction effects of gestational timepoint and maternal BMI on OGTT results were detected, except for the 2-hour value. In women with late GDM, both mean FPG and post-load values were lower in OGTT1 vs. OGTT2. Results were similar employing the IADPSG GDM criteria. CONCLUSIONS: Our findings suggest that gestational-age specific OGTT thresholds for early GDM diagnosis need to be generated.
AIMS: To analyze early-pregnancy oral glucose tolerance test (OGTT) results and differences between early- and late-pregnancy OGTT results in a population-based cohort. METHODS: From 3/2013 to 12/2016, pregnant women in South Karelia, Finland, were invited to undergo a 2-hour 75 g OGTT at 12-16 weeks' gestation (OGTT1) and, if normal, repeat testing at 24-28 weeks (OGTT2). Early and late gestational diabetes (GDM) were diagnosed using the same nationally endorsed criteria (fasting [FPG], 1- or 2-hour plasma glucose ≥5.3, ≥10.0 or ≥8.6 mmol/L, respectively). RESULTS: In OGTT1 (n = 1401), the mean (SD) FPG, 1- and 2-hour values were 4.85 (0.34), 6.63 (1.73) and 5.60 (1.28) mmol/L, respectively. Early GDM was diagnosed in 209 (14.9%). In OGTT2 (n = 1067), late GDM was diagnosed in 114 (10.6%). In women without GDM (n = 953), the mean FPG values were higher and post-load values lower in OGTT1 vs. OGTT2. No interaction effects of gestational timepoint and maternal BMI on OGTT results were detected, except for the 2-hour value. In women with late GDM, both mean FPG and post-load values were lower in OGTT1 vs. OGTT2. Results were similar employing the IADPSG GDM criteria. CONCLUSIONS: Our findings suggest that gestational-age specific OGTT thresholds for early GDM diagnosis need to be generated.