Glucose tolerance in singleton, twin and triplet pregnancies

2016 ◽  
Vol 44 (8) ◽  
Author(s):  
Amir Weissman ◽  
Arie Drugan
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Challenge Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Glucose Challenge Test ◽  
Glucose Challenge ◽  
Mean Glucose ◽  
Twin Pregnancies

AbstractBackground:Data regarding the effects of multifetal pregnancy on the incidence of gestational diabetes mellitus (GDM) are inconsistent and even conflicting. Twin pregnancies have been associated with no increase, a marginal increase or a higher incidence of gestational diabetes. In triplet pregnancies, these effects have not been investigated yet.Objectives:To analyze the results of the glucose challenge and tolerance tests in singleton, twin and triplet pregnancies.Study design:A retrospective database analysis of pregnant women with singletons, twins or triplets who had complete results of the 50 g glucose challenge test (GCT) and the 100 g oral glucose tolerance test (OGTT). The cohort included 12,382 singletons, 515 twins and 39 triplets.Results:There were significantly higher rates of abnormal GCTs in twins and triplets compared to singletons (45.4% and 33.3%, respectively vs. 13.7%, P<0.001 and P<0.05). Significantly higher rates of gestational diabetes in twins (10.1% vs. 2.9 %, P<0.001) and triplets (12.8% vs. 2.9%, P<0.05) compared to singletons were observed. Mean glucose levels after the GCT were higher in twins compared to singletons, and even more in triplets (108 mg/dL in singletons vs. 120 mg/dL in twins vs. 129 mg/dL in triplets, P<0.001).Conclusions:Glucose intolerance is aggravated in multifetal pregnancies. The likelihood of an abnormal GCT and gestational diabetes is higher in twins and triplets compared to singletons.

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

The association between an oral glucose tolerance test performed at term pregnancy and obstetric outcomes

2021 ◽  
pp. 1753495X2110556
Author(s):  
Oren Barak ◽  
Israel Yoles ◽  
Tamar Wainstock ◽  
Noa Gadassi ◽  
Tal Schiller ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Challenge Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Term Pregnancy ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Aims Assessing the value of oral glucose tolerance test performed at term pregnancy in identifying obstetric complications. Methods Retrospective cohort study of women with a normal 50 g glucose challenge test who also had an oral glucose tolerance test at term (defined as at or after 37 weeks of gestation). Comparison between the pathological and normal oral glucose tolerance test groups was performed. Results The mean glucose in the glucose challenge test of women in the normal oral glucose tolerance test ( n = 256) group was lower than that in the pathological oral glucose tolerance test ( N = 16) group (105 ± 17 mg/dl (5.8 ± 0.9 mmol/l) vs 117 ± 13 mg/dl (6.5 ± 0.7 mmol/l), p = 0.007). Relevant obstetrical complications did not differ significantly between the groups. Of note, in the pathological oral glucose tolerance test group only one woman delivered a macrosomic infant. Conclusions A pathological oral glucose tolerance test performed at term was unable to identify women at risk for impaired glucose metabolism-related obstetric complications and is therefore of limited clinical value and seems to be unjustified.

Effect of Prolonged Fasting Duration on 50 Gram Oral Glucose Challenge Test in the Diagnosis of Gestational Diabetes Mellitus

2018 ◽  
Vol 50 (09) ◽  
pp. 671-674
Author(s):  
Necati Hancerliogullari ◽  
Hatice Celik ◽  
Burcu Karakaya ◽  
Aytekin Tokmak ◽  
Yasemin Tasci ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Challenge Test ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Glucose Challenge Test ◽  
Number Of Patients ◽  
Glucose Challenge ◽  
Fasting Duration

AbstractThe aim of this study was to investigate the association between fasting duration before screening with 50 g glucose challenge test (GCT) and the test outcome. For this cross-sectional study, we enrolled 508 low-risk pregnant women who underwent 50 g GCT between the 24 and 28 weeks of gestation. We excluded women with pregestational diabetes, multiple gestations or a history of gestational diabetes mellitus (GDM), and macrosomia. We evaluated fasting durations, GCT results, and demographic features. A significant positive correlation was found between fasting duration and 50 g GCT values (r=0.122; p=0.006), and the best cut-off value was found to be 6.5 h, with 85.85% sensitivity and 38.61% specificity (relative risk, 2.73; 95% CI, 1.893–3.936; p<0.0001). Further, we divided the patients into two groups: study (fasting, <6.5 h; n=146) and control (fasting,>6.5 h; n=362) groups. Notably, the mean glucose levels, number of patients with GCT>140 mg/dl, and rates of unnecessary 100 g loadings were significantly higher in the study group. We found no significant differences between the groups in terms of the fasting plasma glucose levels and GDM prevalence. According to our findings, fasting duration of>6.5 h resulted in 2.7 times more unnecessary 100 g glucose tolerance tests (GTT). We recommend that patients having fasted for>6.5 h receive a one-step 75 g GTT after completing 8-h fasting.

scholarly journals Predictive Characteristics of Elevated 1-Hour Glucose Challenge Test Results for Gestational Diabetes

2017 ◽  
Vol 34 (14) ◽  
pp. 1464-1469
Author(s):  
Yinglei Lai ◽  
Mark Landon ◽  
Susan Ramin ◽  
Brian Casey ◽  
Ronald Wapner ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Challenge Test ◽  
Secondary Analysis ◽  
Tolerance Test ◽  
Change Point Analysis ◽  
Oral Glucose ◽  
Predictive Values ◽  
Glucose Challenge Test ◽  
Glucose Challenge ◽  
Risk Equivalent

Objective The objective was to estimate the optimal screen-positive 1-hour 50 g glucose challenge test (GCT) threshold for gestational diabetes (GDM) and predictive characteristics of increasing screen-positive GCT threshold values (135–199 mg/dL) for GDM. Study Design It is a secondary analysis of a multicenter mild GDM study. At 24 to 30 weeks' gestation, women with elevated GCT (135–199 mg/dL) completed a diagnostic 3-hour oral glucose tolerance test (OGTT). A novel change-point analysis method was used to compare the GDM rates for the adjacent GCT values, delineating categories of changing risk such that values within categories have equal risk for GDM. Positive (PPV) and negative (NPV) predictive values for GDM were computed for increasing GCT cut-offs. Results In 7,280 women with both GCT (135–199 mg/dL) and OGTT results, 4 GDM risk-equivalent GCT categories were identified with escalations at 144, 158, and 174 mg/dL (all p-values <0.05). The PPV for GDM increased from 33 to 64% as GCT increased from 135 to 199 mg/dL, while the NPV decreased from 80 to 67%. PPVs were only 20% and 61% for risk-equivalent categories of 135 to 143 mg/dL and 174 to 199 mg/dL, respectively. Conclusion Elevated GCT cut-off values between 135 and 143 mg/dL may carry equivalent GDM risk. No threshold GCT value <199 mg/dL alone sufficiently predicts GDM.

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