Perinatal Outcomes in Obese Women with One Abnormal Value on 3-Hour Oral Glucose Tolerance Test

2021 ◽  
Author(s):  
Victoria R. Greenberg ◽  
Lisbet S. Lundsberg ◽  
Uma M. Reddy ◽  
William A. Grobman ◽  
Corette B. Parker ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Perinatal Outcomes ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Obese Women ◽  
Oral Glucose Tolerance ◽  
Increased Risk ◽  
The One

Objective This study aimed to determine if one abnormal value of four on the diagnostic 3-hour oral glucose tolerance test (OGTT) is associated with adverse perinatal outcomes in obese women. Study Design This is a secondary analysis of a prospective study of nulliparous women in eight geographic regions. Women with body mass index <30 kg/m2 and pregestational diabetes mellitus (GDM) were excluded. Four groups were compared: (1) normal 50-g 1-hour glucose screen, (2) elevated 1-hour glucose screen with normal 100-g 3-hour diagnostic OGTT, (3) elevated 1-hour glucose screen and one of four abnormal values on 3-hour OGTT, and (4) GDM. Using multivariable logistic regression adjusting for covariates, the women in the groups with dysglycemia were compared with those in the normal screen group for maternal and neonatal outcomes. Results Among 1,713 obese women, 1,418 (82.8%) had a normal 1-hour glucose screen, 125 (7.3%) had a normal 3-hour diagnostic OGTT, 72 (4.2%) had one abnormal value on their diagnostic OGTT, and 98 (5.7%) were diagnosed with GDM. The one abnormal value group had increased risk of large for gestational age (LGA) neonates (adjusted odds ratio [aOR] = 2.24, 95% confidence interval [CI]: 1.31–3.82), cesarean delivery (aOR = 2.19, 95% CI: 1.34–3.58), and hypertensive disorders of pregnancy (aOR = 2.19, 95% CI: 1.32–3.63) compared with normal screens. The one abnormal value group also had an increased risk of preterm birth <37 weeks (aOR = 2.63, 95% CI: 1.43–4.84), neonatal respiratory support (aOR = 2.38, 95% CI: 1.23–4.60), and neonatal hyperbilirubinemia (aOR = 2.00, 95% CI: 1.08–3.71). There was no association between one abnormal value with shoulder dystocia and neonatal hypoglycemia. Conclusion For obese women, one abnormal value on the 3-hour OGTT confers increased perinatal adverse outcomes. These women should be studied further to determine if nutrition counseling and closer fetal monitoring improve outcomes even in the absence of a diagnosis of GDM. Key Points

scholarly journals Role of positive glucose challenge test only versus oral glucose tolerance test in pregnancy outcome: a comparative study

2019 ◽  
Vol 9 (2) ◽  
pp. 1545-1549
Author(s):  
Neha Homagai ◽  
Nirajan Mainali ◽  
Sikha Rijal
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Challenge Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Glucose Challenge Test ◽  
Increased Risk ◽  
Glucose Challenge

Background: Gestational diabetes mellitus is defined as any degree of glucose intolerance which is first recognized during pregnancy and is associated with a number of adverse perinatal outcomes, such as neonatal hypoglycemia, macrosomia with an increased risk of shoulder dystocia and the need for neonatal intensive care. Maternal complications include pre-eclampsia and an increased risk of caesarean delivery. The objective of this study was to compare maternal and perinatal outcomes in pregnant women with positive and negative oral glucose tolerance test following positive glucose challenge test. Materials and Methods: This is a prospective observational hospital based study of 120 patients admitted in Nobel Medical College Teaching Hospital, Biratnagar with glucose challenge test positive pregnancy for delivery. Oral glucose tolerance test was performed in all the glucose challenge test positive pregnant and compared with various maternal parameters and newborn’s conditions. Results: Among 120 patients included in the study, 28 (30.4%) cases were oral glucose tolerance test. Pregnancy induced hypertension was present in 12 cases. Hyperbilirubinemia was present in 42, hypoglycemia in 32, respiratory distress in 44, birth asphyxia in 15 and macrosomia in 6 cases. Conclusions: Pregnancy induced hypertension and hyperbilirubinemia were found to be significantly higher in OGTT positive cases so early detection of GDM screening via is advisable

Does multiple sclerosis affect glucose tolerance?

2013 ◽  
Vol 20 (9) ◽  
pp. 1273-1276 ◽  
Author(s):  
I Wens ◽  
U Dalgas ◽  
N Deckx ◽  
N Cools ◽  
BO Eijnde
Keyword(s):  
Multiple Sclerosis ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Fasting Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Healthy Controls ◽  
Oral Glucose Tolerance ◽  
Increased Risk

Based on current literature, it is not clear if multiple sclerosis (MS) patients are at increased risk to develop impaired glucose tolerance (IGT). Eighty-one MS patients and 45 healthy controls (HC) performed an oral glucose tolerance test. IGT was defined as a fasting glucose concentration of 6.1–6.9 mmol/l and two-hour post-load glucose of 7.8–11.1 mmol/l. The prevalence of impaired fasting glucose concentrations (17% vs 2%) and IGT (11% vs 0%) was higher in MS patients than HC. Accordingly, the areas under the glucose and insulin curves were higher in MS patients. The current study demonstrates an elevated IGT-prevalence in MS.

Cortisol Levels During an Oral Glucose Tolerance Test in Lean and Obese Women

2005 ◽  
Vol 31 (3) ◽  
pp. 213-218 ◽  
Author(s):  
Mehtap Cakir ◽  
Ramazan Sari ◽  
Ozgur Tosun ◽  
Umit Karayalcin
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Obese Women ◽  
Oral Glucose Tolerance ◽  
Cortisol Levels

scholarly journals Kockázatalapú praediabetesszűrés egy vidéki családorvosi praxisban – orális glükóztolerancia-teszt vagy glikált hemoglobin?

2019 ◽  
Vol 160 (50) ◽  
pp. 1976-1983
Author(s):  
Henrietta Galvács ◽  
János Szabó ◽  
Zoltán Balogh
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Glycated Haemoglobin ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Increased Risk

Abstract: Introduction and aim: The aim of this study was to implement a two-stage diabetes screening programme in a severely disadvantaged municipality. In the first stage, diabetes risk assessment was carried out in the 18 to 75 age group, followed by screening of the high risk population for potential carbohydrate metabolism disorders using laboratory tests. Method: Stage 1: assessment of diabetes risk with the FINDRISC questionnaire; Stage 2: identification of carbohydrate metabolism status by oral glucose tolerance test and glycated haemoglobin test in patients with elevated or high risk of diabetes. Results: 406 individuals completed the FINDRISC questionnaire. Elevated or high risk for diabetes was confirmed in 129 individuals (31.77%). There was significant correlation between increased risk and age (p<0.001) and between increased risk and body mass index (p<0.001). Based on the oral glucose tolerance test, 28.3% and 9.43% of the patients were diagnosed with pre-diabetes and diabetes mellitus, respectively. According to the glycated haemoglobin test, the incidences of prediabetes and diabetes were 50.94% and 11.32%, respectively. The strongest predictors of prediabetes/diabetes mellitus was the age (p = 0.047). The correlation between prediabetes/diabetes mellitus and smoking (p = 0.635) and physical activity (p = 0.975) was the weakest. The results showed that the glycated hemoglobin value increased by mean 0.2% by metabolic syndromes patients. Conclusions: Our results highlight the necessity for improving preventative care. Based on the risks of significant mortality and disability due to diabetes, prevention and early diagnosis must be prioritised in primary care. In addition to the oral glucose tolerance test, measurement of glycated haemoglobin is also indicated, while keeping in mind the limitations of its diagnostic value. Evaluating for glycated hemoglobin results, it is also worth looking for the presence of metabolic syndrome. Orv Hetil. 2019; 160(50): 1976–1983.

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