Gestational diabetes: problems associated with the oral glucose tolerance test

Abstract

The oral glucose tolerance test (OGTT) remains the cornerstone for the diagnosis of gestational diabetes (GDM). Due to its multiple problems (expensive, non-physiologic, unpleasant, poor reproducibility, time consuming) [ [1] Hanna F.W.F. Peters J.R. Screening for gestational diabetes; past, present and future. Diabet. Med. 2002; 19: 351-358 Crossref PubMed Scopus (134) Google Scholar ], the American Diabetic Association (ADA) [ [2] Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, Diabet. Care 26 (Suppl.) (2003) S103–S105. Google Scholar ] no longer recommends the OGTT for routine clinical diagnosis of diabetes mellitus in non-pregnant adults. However, the ADA and all other major expert panels like the World Health Organization continue to use it as the “gold-standard” for the diagnosis of GDM, though the quantity of glucose used, the diagnostic criteria and the cut-off values are different [ [1] Hanna F.W.F. Peters J.R. Screening for gestational diabetes; past, present and future. Diabet. Med. 2002; 19: 351-358 Crossref PubMed Scopus (134) Google Scholar ]. This study was undertaken to highlight the problems of using the OGTT for the diagnosis of GDM.