scholarly journals Comparing the first trimester and second trimester fifty grams oral glucose tolerance test values in gestational diabetes mellitus

2021 ◽  
pp. 1-9
Author(s):  
Hasan Turan

Objective: The present study aimed to assess the results of pregnant women who have been applied a 50 g oral glucose tolerance test (OGTT) in the first and second trimesters and investigate this method’s role in the diagnosis of gestational diabetes mellitus (GDM) and risk factors associated with this disease. Material and Methods: This retrospective study was performed on 153 pregnant women who were admitted to our hospital’s antenatal clinics between March 2011 and August 2011. Fifty grams OGTT was applied to the same pregnant women both in the 1st trimester (between 8th and 14th weeks) and second trimester (between 24th and 28th weeks); values of the test results were then compared. A 100 g OGTT di- agnostic test was performed on those with a 50 g OGTT value of ≥140 mg/dl in both trimesters. The study patients were divided into two groups as non-GDM and GDM based on venous plasma glucose values measured 1 h after 50 g of oral glucose load given. The non-GDM group consisted of those with plasma glucose levels <140 mg/ dl and plasma glucose levels between 140 mg/dl and 200mg/dl, GDM group plasma glucose levels ≥200 mg/dl. First trimester and second-trimester OGTT values and possible risk factors for GDM (age, gravida, parity, number of abortions, smoking, a previous GDM history, etc.) were compared between non-GDM and GDM groups. Results: GDM, diagnosed in 4.5% (7) in the first trimester (between 8th and 14th weeks) and 6.5% (10) second trimester, was detected in 11% (17) of 153 pregnant women in the present study. GDM, diagnosed in 41.2% (7 patients) in the first trimester and 58.8% (10 patients) second trimester, was found with a higher rate in pregnant women over 30 years (p=0.000 <0.05). The mean fasting blood glucose (FBG) level was 96 mg/dl in the GDM group and 83 mg/dl in the non-GDM group, with a statistically sig- nificant difference, which existed (p<0.05). The mean 50 g OGTT value was 170 mg/ dl in pregnant women diagnosed with GDM in the first trimester, and it was 140 mg/dl in those diagnosed in the second trimester, with this difference was considered statis- tically different (p<0.05). Age, parity, a family history of DM, FBG, a previous GDM his- tory, gravida, a previous macrosomia history, and a previous history of preeclampsia were determined as risk factors that significantly increase the risk of GDM (p<0.05). The half of patients was diagnosed with GDM in the early period of pregnancy. In the present study, 41.2% of cases were diagnosed in the first trimester and 58.8% in the second trimester. In general, the patients diagnosed in the first trimester were those being under risk in terms of GDM. According to the present study, it is recommended that the pregnant women should be scanned for GDM in the early period. Conclusion: With screening tests to be applied to risky groups in early pregnancy, a significant number of cases with GDM recently be detected on time. Thereby, mater- nal and fetal morbidity and mortality rates might be considerably reduced thanks to providing proper treatments and regular monitoring. Furthermore, for obtaining spe- cific data concerning the factors with potential influence on the risk of GDM, further studies on this topic need to be performed.

2021 ◽  
Vol 29 ◽  
pp. 57-63
Author(s):  
Jiayu Lu ◽  
Song Zhang ◽  
Hongqing Jiang ◽  
Lin Yang ◽  
Dongmei Hao ◽  
...  

BACKGROUND: Oral glucose tolerance test (OGTT) is a standard for the diagnosis of gestational diabetes mellitus (GDM). However, clinically, some cases with normal results were diagnosed as GDM in the third trimester. OBJECTIVE: To establish a risk model based on energy metabolism, epidemiology, and biochemistry that could predict the GDM pregnant women with normal OGTT results in the second trimester. METHODS: Qualitative and quantitative data were analyzed to find out the risk factors, and the binary logistic backward LR regression was used to establish the prediction model of each factor and comprehensive factor, respectively. RESULTS: The risk factors including the rest energy expenditure per kilogram of body weight, oxygen consumption per kilogram of body weight, if more than the weight gain criteria of the Institute of Medicine, the increase of body mass index between the second trimester and pre-pregnancy, and fasting blood glucose. By comparison, the comprehensive model had the best prediction performance, indicating that 85% of high-risk individuals were correctly classified. CONCLUSION: Energy metabolism, epidemiology, and biochemistry had better recognition ability for the GDM pregnant women with normal OGTT results in the second trimester. The addition of metabolic factors in the second trimester also improved the overall prediction performance.


2017 ◽  
Vol 5 (1-2) ◽  
pp. 49-53
Author(s):  
Zinat Begum ◽  
Dewan Shahida Banu ◽  
Shaila Sharmeen Shanta ◽  
Shitil Ibna Islam

Objective: The present study was undertaken to determine the risk factors for Gestational Diabetes Mellitus (GDM) presented at Bangladesh Institute of Research in Diabetes, Endocrine & Metabolic Disorders (BIRDEM). Materials & methods: The present case-control study was conducted at BIRDEM Hospital, Dhaka over a period of 6 months from July to December 2011. A total of 100 pregnant women (20 cases and 80 controls) were consecutively enrolled in the study. Pregnant women who developed diabetes at their 3rd trimester were cases (n = 20), while pregnant women free from diabetes at their 3rd trimester were controls (n = 80). The diagnosis of GDM was made using a two-step approach. Pregnant women were initially screened by measuring the plasma glucose concentrations 1 hour after a 50 gram of oral glucose challenge. A diagnostic oral glucose tolerance test was performed on the subset of women whose plasma glucose concentrations exceded the threshold value for glucose (> 140 mg/dl). Result: The study showed that older patients (≥ 25 years) were predominant in both case and control groups. The groups were almost comparable in terms of socioeconomic status and occupation. The distribution of gestational age was also similar between groups (33.1 ± 6.3 vs. 34.2 ± 3.9 years, p = 0.476). Majority (85%) of the cases had family history of diabetes (p < 0.001). Thirty five percent of cases were nulipara and 65% multipara compared to 51.3% and 48.7% respectively of the control (p = 0.076). No significant difference was observed between the groups in terms of preterm labour and PROM (p = 0.690 and 0.220 respectively). Forty percent of cases had past history of GDM compared to 3.8% of controls (p < 0.001). The fasting plasma glucose and plasma glucose 2 hrs after 75 g of glucose ingestion were significantly higher in pregnant women having GDM than those in normal pregnant women (8.3 ± 3.1 vs. 4.1 ± 0.5 mmol/L, p < 0.001;12.9 ± 4.8 vs. 5.9 ± 1.2 mmol/L, p < 0.001 respectively). Conclusion: The study concluded that none of the sociodemographic characteristics like age, socioeconomic status and occupation was found to be associated with GDM. However, pregnant women with family history of diabetes are at risk of developing GDM significantly more than those without GDM. Multipara tend to develop GDM more frequently than the primipara does. Past incidence of GDM increases the risk of GDM in the subsequent pregnancy. Ibrahim Card Med J 2015; 5 (1&2): 49-53


2022 ◽  
Vol 11 (2) ◽  
pp. 384
Author(s):  
Ilona Juchnicka ◽  
Mariusz Kuźmicki ◽  
Piotr Zabielski ◽  
Adam Krętowski ◽  
Agnieszka Błachnio-Zabielska ◽  
...  

We hypothesized that sphingolipids may be early biomarkers of gestational diabetes mellitus (GDM). Here, 520 women with normal fasting plasma glucose levels were recruited in the first trimester and tested with a 75 g oral glucose tolerance test in the 24th–28th week of pregnancy. Serum sphingolipids concentrations were measured in the first and the second trimester by ultra-high performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC/MS/MS) in 53 patients who were diagnosed with GDM, as well as 82 pregnant women with normal glucose tolerance (NGT) and 32 non-pregnant women. In the first trimester, pregnant women showed higher concentrations of C16:0, C18:1, C22:0, C24:1, and C24:0-Cer and lower levels of sphinganine (SPA) and sphingosine-1-phosphate (S1P) compared to non-pregnant women. During pregnancy, we observed significant changes in C16:0, C18:0, C18:1, and C24:1-Cer levels in the GDM group and C18:1 and C24:0-Cer in NGT. The GDM (pre-conversion) and NGT groups in the first trimester differed solely in the levels of C18:1-Cer (AUC = 0.702 p = 0.008), also considering glycemia. Thus, C18:1-Cer revealed its potential as a GDM biomarker. Sphingolipids are known to be a modulator of insulin resistance, and our results indicate that ceramide measurements in early pregnancy may help with GDM screening.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Inés Urrutia ◽  
◽  
Alicia Martín-Nieto ◽  
Rosa Martínez ◽  
J Oriol Casanovas-Marsal ◽  
...  

AbstractThe aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mayu Watanabe ◽  
Akihiro Katayama ◽  
Hidetoshi Kagawa ◽  
Daisuke Ogawa ◽  
Jun Wada

Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group;n=10) and without insulin therapy (Diet group;n=27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239) using forward selection method and 1.192 (1.006–1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.


2021 ◽  
Vol 122 (4) ◽  
pp. 285-293
Author(s):  
Burak Bayraktar ◽  
Meric Balikoglu ◽  
Miyase Gizem Bayraktar ◽  
Ahkam Goksel Kanmaz

This study is aimed at determination whether pregnant women who develop hyperemesis gravidarum in the first trimester have a tendency to develop gestational diabetes mellitus (GDM). It is also aimed at identification of effects of hyperemesis gravidarum and GDM on prenatal and neonatal status in case they were detected together. Hyperemesis gravidarum diagnose was based on the following signs and symptoms. To diagnose GDM, first trimester fasting blood glucose measurement and subsequent blood glucose monitoring and 75-g oral glucose tolerance test (OGTT) were performed in the second trimester. A total of 949 singleton pregnant women (95 with and 852 without hyperemesis gravidarum) who met our criteria were included in the study. In the first trimester, plasma blood glucose and positive GDM screening were found to be significantly higher in the hyperemesis gravidarum group compared to the control group (p=0.042 and p<0.001, respectively). However, actual GDM cases were similar between both groups. The positive predictive value was significantly lower in the hyperemesis gravidarum group (28.5% vs. 72.7%, p=0.003). In the second trimester, the prevalence of GDM was 6.6% in the hyperemesis gravidarum group and 7.3% in the control group, with no significant difference (p=0.218) between-groups. In this study, hyperemesis gravidarum was found to cause changes in maternal metabolism in the first trimester of pregnancy due to limited calorie intake and fasting; in the presence of hyperemesis gravidarum, it should be known that the positive predictive value of first trimester gestational diabetes screening may decrease and the diagnosis of pseudo-GDM may increase.


2008 ◽  
Vol 10 (Number 1) ◽  
pp. 10-15
Author(s):  
D K Sunyal ◽  
Md. R Amin ◽  
MH Md. R ◽  
GM Kibria ◽  
G M Molla ◽  
...  

In the present study the partial pressure of carbon dioxide in arterial blood (PaC0:1 and respiratory rate (RR) were studied in pregnant and non-pregnant women in Dhaka city. Far this purpose a total 32 women for PaCO)and 100 women for RR with age ranging front 25 ...ears le 35 years without any recent history of respiratory diseases were selected. Normal pregnant women were taken as e.yperimental group and healthy nor-pregnant ...omen as return!. Data was collected during first trimester. second trimester and third trimester in pregnant women and also nompregnant women. The PaCOrwas determined by using 'EASY BLOOD GAS .0TO INALMER" and RR was recorded. The PaCO, and RR during different trimesters of pregnant .rumen were compared with that of non-pregnant 11.1101. Statistical analysis was drum with .tudents '1' rest. The PeCOr was significantly lower in first trimester, second trimester and third (rimester of pregnant women than that of non-pregnant women. Similarly, RR was significantly higher in first trimester. second trimester and third trimester of pregnant women than that of nonpregnant women. Again RR was significantly higher in third trimester than in first trimester and second trimester of pregnant women. There were no statistically significant difference of PaCO, among first trimester. second trimester and third trimester of pregnant women. Similarly, there were no statistically significant difference of RR between first trimester and second trimester of pregnant women. It may be concluded from the study that the progressively decreased PaCO• and increased RR throughout Me pregnancy were most likely MP be related to the effect of progesterone-induced hyperventilation. Hypermfilation in pregnancy is due to hypersensitivity of respiratory centre. Due to hyperventilation there is expel out of CO, miming decrease in PaC0r and increase in RR during pregnancy.


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