Perinatal outcome in gestational diabetes according to different diagnostic criteria

2019 ◽  
Vol 47 (5) ◽  
pp. 553-557 ◽  
Author(s):  
Lina Salman ◽  
Anat Pardo ◽  
Eyal Krispin ◽  
Galia Oron ◽  
Yoel Toledano ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Challenge Test ◽  
Perinatal Outcomes ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Neonatal Hypoglycemia ◽  
Glucose Challenge ◽  
Nicu Admission

Abstract Objectives To evaluate whether gestational diabetes mellitus (GDM) diagnosed by different criteria impacts perinatal outcome. Methods This was a retrospective study of deliveries with a diagnosis of GDM (2014–2016). Perinatal outcomes were compared between patients with: (1) GDM diagnosed according to a single abnormal value on the 100-g oral glucose tolerance test (OGTT); (2) two or more abnormal OGTT values; and (3) a 50-g glucose challenge test (GCT) value ≥200 mg/dL. Results A total of 1163 women met the inclusion criteria, of whom 441 (37.9%) were diagnosed according to a single abnormal OGTT value, 627 (53.9%) had two or more abnormal OGTT values and 95 (8.17%) had a GCT value ≥200 mg/dL. Diet-only treatment was significantly higher in the single abnormal value group (70.3% vs. 65.1% vs. 50.5%) and rates of medical treatment were significantly higher in the GCT ≥ 200 mg/dL group (P < 0.05). Women in the GCT ≥ 200 mg/dL group had higher rates of neonatal intensive care unit (NICU) admission (10.5% vs. 2.7% vs. 2.8%, P < 0.001) and neonatal hypoglycemia (5.3% vs. 0.5% vs. 0.8%, P < 0.001). On multivariate logistic regression, GCT ≥ 200 mg/dL was no longer associated with higher rates of NICU admission and neonatal hypoglycemia (P > 0.05). Conclusion No difference was noted in the perinatal outcome amongst the different methods used for diagnosing GDM.

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 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.

scholarly journals The Glucose Challenge Test for Screening of Gestational Diabetes

2012 ◽  
Vol 9 (2) ◽  
pp. 22-25 ◽  
Author(s):  
A Shrestha ◽  
C D Chawla
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Diagnostic Yield ◽  
Mode Of Delivery ◽  
Challenge Test ◽  
Tolerance Test ◽  
Modern Trend ◽  
Oral Glucose ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Background The frequency of gestational diabetes mellitus (GDM) is 0.6% -15% of pregnant woman. The modern trend towards the delay starting family is the main factor responsible for increase prevalence of GDM. This condition is associated with the adverse effect on mother and fetus, so it is important to find out the GDM by screening of all the pregnant women. Objective To observe the feasibility of using the 50g GCT for all pregnant women attending Dhulikhel Hospital, Obstetric OPD. To determine the incidence of gestational diabetes in the population and to observe the maternal and fetal outcome among those having an elevated GCT level and gestational diabetes. Methods A prospective and analytical study of 1598 pregnant women booked and delivered between June 2009and August 2010. Glucose challenge test (GCT) performed by using 50gm glucose and diagnosis of gestational diabetes performed by using the Carpenter Coustan Criteria. Pregnancy outcomes were assessed by the gestation and mode of delivery. Similarly, neonatal outcomes assessed in terms of birth weights, APGAR scores, congenital abnormalities, hyperbilirubinaemia, hypoglycaemia or respiratory distress syndrome. Results The detected incidence of gestational diabetes was 0.75%. With the threshold plasma glucose level at140 mg/ dl, 198 women needed to undergo the 100g oral glucose tolerance test and 12 women had gestational diabetes. The diagnostic yield was 6.06%. Perinatal outcome was similar to the rest of the women with normal glucose challenge test. Conclusions The 50g GCT is feasible and also helps to find out GDM. It is easy, user friendly, cheap and convenient for screening purpose. DOI: http://dx.doi.org/10.3126/kumj.v9i2.6282  Kathmandu Univ Med J 2011;9(2):22-25

scholarly journals Fetomaternal outcome in elevated Glucose Challenge Test and gestational diabetes

2018 ◽  
Vol 13 (1) ◽  
pp. 41-45
Author(s):  
Abha Shrestha ◽  
B Kayastha ◽  
N Pradhan
Keyword(s):  
Gestational Diabetes ◽  
Mode Of Delivery ◽  
Challenge Test ◽  
Tolerance Test ◽  
Adverse Outcomes ◽  
Oral Glucose ◽  
Glucose Challenge Test ◽  
Glucose Challenge ◽  
Elevated Glucose ◽  
In Pregnancy

Aims: To observe the maternal and fetal outcome among those having elevated Glucose Challenge Test (GCT) level and gestational diabetes mellitus (GDM).Methods: Medical record of 15,413 pregnant women booked and delivered between June 2012 and January 2018 were evaluated. GCT was performed by using 50gm glucose and diagnosis of gestational diabetes performed by using the Carpenter Coustan Criteria. Pregnancy outcomes were assessed by the antenatal events, gestation and mode of delivery. Similarly, neonatal outcomes assessed in terms of birth weights, Apgar score, congenital abnormalities, hyperbilirubinaemia, hypoglycaemia and respiratory distress syndrome.Results: The detected incidence of gestational diabetes was 2.35%. With the threshold plasma glucose level at 140 mg/ dl, 1843 women needed to undergo 100g oral glucose tolerance test and 363 women had gestational diabetes.Conclusions: It is very important to find out GDM in pregnancy as it has adverse outcomes which are preventable; it is worthwhile to detect GDM by screening in pregnancy. The 50g GCT is feasible and 100gm OGTT to find out GDM.

scholarly journals Prevalenceof gestational diabetes and pregnancy outcome in Pakistan

2021 ◽  
Vol 2 (2) ◽  
pp. 268-273 ◽  
Author(s):  
F. Jawad ◽  
P Irshad uddin
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Pregnancy Outcome ◽  
Fasting Blood Glucose ◽  
Challenge Test ◽  
Diet Therapy ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Glucose Challenge ◽  
Mean Blood Glucose

Prevalence of gestational diabetes mellitus and the pregnancy outcome of women registered at the Aga Khan Maternity Home, Karachi was studied. Initial screening was by a glucose challenge test with 50 g glucose. If the 1-hour blood glucose level exceeded 130 mg%, then a 3-hour oral glucose tolerance test with 100 g glucose was performed. Diagnosis was based on O’Sullivan’s criteria. Insulin was prescribed if the fasting blood glucose was more than 95 mg%, and the 2-hour post-prandial over 125 mg%, after a week of diet therapy. The prevalence of gestational diabetes was 3.45% with an aggregate birth weight of 3.24 kg, and perinatal loss of 2.08%. The mean blood glucose values were 93.46 mg% fasting and 117.03 mg%, 2 hours post-prandial

scholarly journals The application of 50g oral glucose challenge test in screening for gestational diabetes mellitus in patients attending antenatal care OPD

2017 ◽  
Vol 6 (5) ◽  
pp. 1952
Author(s):  
Disha Andhiwal Rajput ◽  
Jaya Kundan Gedam
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Gestational Hypertension ◽  
Challenge Test ◽  
Oral Glucose ◽  
Average Risk ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Background: To screen patients at average risk for Gestational Diabetes using 50g Glucose Challenge test, to ascertain the prevalence of Gestational diabetes through further diagnostic testing and to prevent and manage complications. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Women with GDM are at risk for maternal and foetal complications, so it is important to screen all the pregnant woman.Methods: This study was conducted in 198 patients between 24 and 28 weeks of gestation, attending the Antenatal clinic. 50g oral glucose is administered irrespective of time of the last meal and plasma glucose is measured one hour later. Patients with plasma glucose levels more than 140 mg/dl were subjected to a 100g oral glucose tolerance test, patients with two or more abnormal reading were labelled as GDM and managed accordingly.Results: Prevalence of GDM in our study was 9.59%. Maternal complications like gestational hypertension, vaginal infections and foetal complications were much higher in GDM patients as compare to non GDM group.Conclusions: GDM is a disease which adversely affects both mother as well as foetus. It is concluded that 50 gm glucose challenge test at 24-28 weeks of gestation with a cut-off value of 140 mg/dl is a reliable screening test for GDM. This test offers the best combination of ease and economy of use and reproducibility in screening for gestational diabetes mellitus in average risk patients.

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