850: Trends in Glucose Challenge test results: A population based study of over a decade

Abstract

The incidence and prevalence of diabetes is constantly rising in the western world, partly due to the aging global population and the obesity pandemic. Gestational diabetes rates seem to be rising as well, due to similar reasons. One-hour glucose challenge test (GCT), measuring the effect of 50-grams glucose solution on blood glucose levels, is generally performed during pregnancy in young healthy women, with no previous history of impaired fasting glucose, gestational diabetes, morbid obesity, etc. We sought to analyze trends over the years in GCT results in a large population of healthy parturients. Data was gathered from a computerized database of a large Health Maintenance Organization, including all GCTs performed between 2006 and 2015. Mean GCT results were evaluated over the years and the incidence of abnormal results (>140 mg/dl). Time series analysis was performed to test the yearly trend, and a multivariable logistic model was constructed to study the risk for abnormal results over the years, while adjusting for maternal age. During the study period 92,676 GCT tests were available for analysis. Mean maternal age, mean GCT results and the incidence rates of abnormal results (>140mg/dl) all increased over the years: 28.7±5.1y in the first year (2006) to 30.1±5.1y in the last year (2015), 106±29 to 113±29 mg/dl, and 12.3% to 16.4%, with a positive trend over the years for all variables (p for trend <0.001 for all) (Graph). A multivariable logistic model revealed that later years were associated with an increased risk for abnormal GCT result, while adjusting for maternal age (Adj. OR=1.07; 95%CI 1.07-1.08). GCT is a screening test generally performed in pregnant women with no diabetic predisposition. In this large population, the mean GCT results gradually increase over a period of a decade by an average of 7 mg/dl and the incidence of abnormal GCT rises in parallel. This rise cannot be explained only by the aging population but rather by other modern western life characteristics.