The Analytical Reliability of the Oral Glucose Tolerance Test for the Diagnosis of Gestational Diabetes: An Observational, Retrospective Study in a Caucasian Population.

Basilio Pintaudi,Emilia Biamonte,Francesca Chiereghin,Rosario D’Anna,Francesco Corrado,Giacoma Di Vieste,Antonino Di Benedetto

doi:10.3390/jcm11030564

Basilio Pintaudi, Emilia Biamonte + Show 5 more

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https://doi.org/10.3390/jcm11030564

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Abstract

The Oral Glucose Tolerance Test (OGTT) is currently the gold standard reference test for the diagnosis of gestational diabetes mellitus (GDM). Several critical issues related to analytical variables have challenged its reproducibility and accuracy. This study aimed to assess the analytical reliability of the OGTT for the diagnosis of GDM. A total of 1015 pregnant women underwent a 2 h 75 g OGTT between 24 and 28 weeks of gestation. As recommended by National Academy of Clinical Biochemistry, we considered the total maximum allowable error for glucose plasma measurement as <6.9%. Assuming the possibility of analytical errors within this range for each OGTT glucose plasma value, different scenarios of GDM occurrence were estimated. GDM prevalence with standard criteria was 12.2%, and no hypothetical scenarios have shown a comparable GDM prevalence. Considering all the three OGTT values estimated at the lowest or the highest allowed value according to total maximum allowable error, GDM prevalence significantly varied (4.5% and 25.3%, respectively). Our results indicate that the OGTT is not completely accurate for GDM diagnosis.

Highlights

Considering all Oral Glucose Tolerance Test (OGTT) glucose values estimated at the lowest or highest allowed value according to the total maximum allowable error, we would have a gestational diabetes mellitus (GDM) prevalence of 4.5%
Our study explored the analytical reliability of the OGTT in diagnosing GDM
GDM prevalence significantly varied depending on the OGTT glucose level estimates at the lowest or highest allowed value according to the total maximum allowable error

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Gestational diabetes mellitus (GDM) is defined as any degree of hyperglycemia with the first onset during gestation [1]. It occurs mainly during the second or third trimester of gestation. GDM affects approximately 7% of pregnancies worldwide [2] and its incidence rate is predicted to increase in the near future [2]. Two factors have been reported to promote impaired glucose control that leads to GDM onset: first, a reduced basal pancreatic islet cell function; second, the insulin resistance resulting from an increased maternal and placental hormonal production [3]

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