Abstract
Background: There is a no consensus over the most sensitive and practical approach to diagnose Gestational Diabetes Mellitus (GDM). The standard 75 grams glucose tolerance test (GTT) is widely practiced to diagnose GDM. However, non-fasting 75-gram Glucose Challenge Test (GCT) with the 2-hour cutoff value of ≥ 140mg/dL is also recommended by some professional bodies. The aim of this study was to investigate the sensitivity and specifiity of GCT when compared to GTT for diagnosing GDM. Methods: Pregnant women in period of gestation between 24- 28 weeks were recruited by simple random sampling method. Non fasting 75g GCTs were performed in all followed by fasting 75g GTTs within a week time. International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria of GTT were used as t he reference test to diagnose GDM and 2-hour value of GCT was compared. Findings: According to IADPSG criteria, 21.5% (59/274) of pregnant women had GDM, in compared to 13.1% (36/274) detected by GCT. Sensitivity and specifiity of GCT were 40.6% and 94.4% respectively. The area under the ROC curve for the ability of 2-hour value of GCT to predict GDM detected by GTT was 0.758 (SE 0.039). According to GTT values, FBS ≥ 92 mg/dL alone recognized 11.7% (32/274) of study sample as having GDM. Additional 9.1% (25/274) and 0.7% (2/274) of GDM cases were detected with 1-hour value≥180 mg/dL and 2-hour hour value ≥ 153 respectively. Conclusion: GCT with 2-hour cutoff value ≥ 140mg/dL is not sensitive enough to diagnose GDM recognized by GTT.
Highlights
There is a no consensus over the most sensitive and practical approach to diagnose Gestational Diabetes Mellitus (GDM)
International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria of glucose tolerance test (GTT) were used as the reference test to diagnose Gestational diabetes mellitus (GDM) and 2-hour value of Glucose Challenge Test (GCT) was compared
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and it is associated with increased risk of several adverse perinatal and maternal outcomes [1, 2]
Summary
There is a no consensus over the most sensitive and practical approach to diagnose Gestational Diabetes Mellitus (GDM). Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and it is associated with increased risk of several adverse perinatal and maternal outcomes [1, 2]. The landmark study of Hyperglycemia and Adverse Pregnancy Outcome (HAPO) as well as many other studies including the Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) trial had shown maternal hyperglycemia less severe than that used to define overt diabetes was related to clinically important perinatal disorders or problems and that their effects can be reduced by means of treatment [5] [6].
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