Do Pregnancy Outcomes of Women With False-Positive Early Gestational Diabetes Mellitus Differ From Those of Women With Normal Glucose Tolerance?

Abstract Background: To investigate whether false-positive early gestational diabetes mellitus (GDM) women can be managed similarly as normal glucose tolerance (NGT) women.Methods: This retrospective study was conducted at a tertiary care center in Japan. Pregnancy and neonate outcomes of 117 singleton pregnancies with false-positive early GDM and 1774 singleton pregnancies with NGT who delivered after 22 weeks of gestation were compared. GDM was diagnosed according to the IADPSG criteria (patients having one or more of the following: fasting plasma glucose ≥ 92 mg/dL and a 75 g oral glucose tolerance test (OGTT) value ≥180 mg/dL at 1 h, or ≥153 mg/dL at 2 h). Pregnant women diagnosed with GDM in early pregnancy who did not meet the diagnostic criteria on the second OGTT were defined as having false-positive early GDM. Women with false-positive early GDM did not receive any therapeutic intervention during gestation.Results: Maternal age, pre-pregnancy BMI, and gestational weight gain were significantly higher in the false-positive GDM group than the NGT group. No significant differences were found in pregnancy outcomes, including gestational age, birth weight, large for gestational age rate, and cesarean delivery rate. Except for neonatal hypoglycemia rate, no significant differences were found in neonatal outcomes.Conclusions: There were no clinically significant differences between early GDM false-positive women exhibiting GDM patterns only during early pregnancy and NGT women. False-positive early GDM women can be managed similarly as NGT women, suggesting that WHO diagnostic guidelines, applying the IADPSG criteria during early pregnancy, need revision.

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Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: a subanalysis of the St Carlos GDM Prevention Study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2018-000550 ◽

2018 ◽

Vol 6 (1) ◽

pp. e000550 ◽

Cited By ~ 14

Author(s):

Carla Assaf-Balut ◽

Nuria Garcia de la Torre ◽

Alejandra Durán ◽

Manuel Fuentes ◽

Elena Bordiú ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnancy Outcomes ◽

Nutrition Therapy ◽

Normal Glucose Tolerance ◽

Medical Nutrition Therapy ◽

Prevention Study ◽

Normal Glucose ◽

Medical Nutrition

ObjectivesTo assess whether Mediterranean Diet (MedDiet)-based medical nutrition therapy facilitates near-normoglycemia in women with gestational diabetes mellitus (GDMw) and observe the effects on adverse pregnancy outcomes.Research design and methodsThis is a secondary analysis of the St Carlos GDM Prevention Study, conducted between January and December 2015 in Hospital Clínico San Carlos (Madrid, Spain). One thousand consecutive women with normoglycemia were included before 12 gestational weeks (GWs), with 874 included in the final analysis. Of these, 177 women were diagnosed with gestational diabetes mellitus (GDM) and 697 had normal glucose tolerance. All GDMw received MedDiet-based medical nutrition therapy with a recommended daily extra virgin olive oil intake ≥40 mL and a daily handful of nuts. The primary goal was comparison of hemoglobin A1c (HbA1c) levels at 36–38 GWs in GDMw and women with normal glucose tolerance (NGTw).ResultsGDMw as compared with NGTw had higher HbA1c levels at 24–28 GWs (5.1%±0.3% (32±0.9 mmol/mol) vs 4.9%±0.3% (30±0.9 mmol/mol), p=0.001). At 36–38 GWs values were similar between the groups. Similarly, fasting serum insulin and homeostatic model assessment insulin resitance (HOMA-IR) were higher in GDMw at 24–28 GWs (p=0.001) but became similar at 36–38 GWs. 26.6% of GDMw required insulin for glycemic control. GDMw compared with NGTw had higher rates of insufficient weight gain (39.5% vs 22.0%, p=0.001), small for gestational age (6.8% vs 2.6%, p=0.009), and neonatal intensive care unit admission (5.6% vs 1.7%, p=0.006). The rates of macrosomia, large for gestational age, pregnancy-induced hypertensive disorders, prematurity and cesarean sections were comparable with NGTw.ConclusionsUsing a MedDiet-based medical nutrition therapy as part of GDM management is associated with achievement of near-normoglycemia, subsequently making most pregnancy outcomes similar to those of NGTw.

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High probability of false-positive gestational diabetes mellitus diagnosis during early pregnancy

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001234 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001234

Author(s):

Sayuri Nakanishi ◽

Shigeru Aoki ◽

Junko Kasai ◽

Ryosuke Shindo ◽

Soichiro Obata ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Early Pregnancy ◽

Therapeutic Intervention ◽

False Positive ◽

Early Onset ◽

Oral Glucose ◽

Study Cohort ◽

Iadpsg Criteria

IntroductionThis study aimed to assess the validity of applying the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) at any time during pregnancy.Research design and methodsThis multicenter cohort study was conducted at five Japanese facilities from January 2018 to April 2019. The study cohort included women at a high risk of GDM who met one or more of the following IADPSG criteria during early pregnancy: fasting plasma glucose (FPG) ≥92 mg/dL and 75 g oral glucose tolerance test (OGTT) value of ≥180 mg/dL at 1 hour, or ≥153 mg/dL at 2 hour (hereafter early-onset GDM). Women diagnosed with early-onset GDM were followed up without therapeutic intervention and underwent the 75 g OGTT again during 24–28 weeks of gestation. Those exhibiting the GDM patterns on the second 75 g OGTT were diagnosed with true GDM and treated, whereas those exhibiting the normal patterns were diagnosed with false positive early GDM and received no therapeutic intervention.ResultsOf the 146 women diagnosed with early-onset GDM, 69 (47%) had normal 75 g OGTT values at 24–28 weeks of gestation, indicating a false-positive result. FPG levels were significantly higher in the first 75 g-OGTT test than in the second 75 g-OGTT test (93 mg/dL and 87.5 mg/dL, respectively; p<0.001). FPG levels were high in 86 (59%) women with early-onset GDM during early pregnancy but in only 39 (27%) women during mid-pregnancy. Compared with false positive early GDM, true GDM was more frequently associated with adverse pregnancy outcomes.ConclusionsAlthough women with early-onset GDM were followed up without treatment, the results of repeated 75 g OGTT during mid-pregnancy were normal in about 50%. Our data did not support the adoption of IADPSG thresholds for the diagnosis of GDM prior to 20 weeks of gestation.

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Glycemic variability in normal glucose tolerance women with the previous gestational diabetes mellitus

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-015-0077-5 ◽

2015 ◽

Vol 7 (1) ◽

Cited By ~ 11

Author(s):

Yong-mei Wang ◽

Li-hua Zhao ◽

Jian-bin Su ◽

Hai-feng Qiao ◽

Xiao-hua Wang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Glycemic Variability ◽

Normal Glucose Tolerance ◽

Normal Glucose ◽

Previous Gestational Diabetes Mellitus ◽

Previous Gestational Diabetes

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Faculty Opinions recommendation of Normal glucose tolerance and gestational diabetes mellitus: what is in between?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1260965.728065 ◽

2009 ◽

Author(s):

Marion Franz

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Normal Glucose Tolerance ◽

Normal Glucose

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Clinically Useful Estimates of Insulin Sensitivity During Pregnancy: Validation studies in women with normal glucose tolerance and gestational diabetes mellitus

Diabetes Care ◽

10.2337/diacare.24.9.1602 ◽

2001 ◽

Vol 24 (9) ◽

pp. 1602-1607 ◽

Cited By ~ 139

Author(s):

J. P. Kirwan ◽

L. Huston-Presley ◽

S. C. Kalhan ◽

P. M. Catalano

Keyword(s):

Diabetes Mellitus ◽

Insulin Sensitivity ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Validation Studies ◽

Normal Glucose Tolerance ◽

Normal Glucose

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The Role of Osteocalcin in Placenta Function in Gestational Diabetes Mellitus

10.21203/rs.3.rs-379456/v1 ◽

2021 ◽

Author(s):

Liang Song ◽

Yiming Huang ◽

Junqing Long ◽

Yuanfan Li ◽

Zongqin Pan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Umbilical Vein ◽

Normal Glucose Tolerance ◽

Maternal Serum ◽

Diabetes Mellitus Group ◽

Human Trophoblast ◽

Normal Glucose

Abstract Background: Evidence for osteocalcin role in glucose and energy metabolism is increasing. However, little is known about osteocalcin function in gestational diabetes mellitus. The aim of this study is to examine the associations between osteocalcin and gestational diabetes mellitus. Method: 36 patients with gestational diabetes mellitus and 40 normal glucose tolerance controls were recruited in the Maternal and Child Health Hospital Guangxi Zhuang Autonomous Region from May to August 2018. Total osteocalcin and biochemical indexes of maternal serum and umbilical vein serum were analyzed. Transcriptome of placenta were sequenced. Human trophoblast JAR cells were used for evaluated the affection of osteocalcin on trophoblast In vitro. There were no significant differences with maternal serum total osteocalcin levels between gestational diabetes mellitus and normal glucose tolerance groups. The gestational diabetes mellitus group has lower umbilical vein serum total osteocalcin (51.46 ng/mL ± 24.29 Vs 67.00 ng/mL ± 25.33, P = 0.008 ), lower adiponectin (1099.72 μg/L ± 102.65 Vs 1235.85 μg/L ± 94.63, P < 0.001), higher leptin (7.41 μg/L ± 0.28 Vs 6.02 μg/L ± 0.31, P ＜ 0.001). A significant relationship existed between umbilical vein serum total osteocalcin levels and leptin (r = -0.456, P = 0.007). Osteocalcin promote JAR trophoblast cells proliferation and HCG synthesis. 36 correlated gene modules of placental transcriptome were identified through weighted gene co-expression network analysis, 2 of them were associated with osteocalcin. Conclusion: lower osteocalcin in umbilical vein serum is associated with gestational diabetes mellitus, osteocalcin may regulate placenta function via adiponectin.

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