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 GESTATIONAL DIABETES MELLITUS

2012 ◽  
Vol 19 (04) ◽  
pp. 462-468
Author(s):  
M. IKRAM ◽  
SYED HAIDER HASAN ALAM ◽  
SHAFQAT MUKHTAR ◽  
M. Saeed
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Glucose Tolerance Test ◽  
Fasting Blood Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Introduction: Gestational diabetes mellitus is common disorder in pregnancy. It is associated with adverse pregnancy outcome. There is no consensus regarding the optimal approach to screening of gestational diabetes mellitus. The present study has tried toobserve the value of fasting blood glucose in screening of gestational diabetes. Objective: To determine the frequency of patients in whomfasting blood glucose and 100gm glucose tolerance show agreement for screening of gestational diabetes mellitus at 24 -28 wks. Studydesign: Comparative cross sectional study. Settings: The study was conducted at Gynecology and Obstetrics department Shaikh ZayedFederal Post Graduate Institute Lahore. Duration of study with dates: 6 months from 12Nov 2010 to 11 May 2011. Material and method: Thestudy included 135 booked patients with positive family history of diabetes mellitus. All patients underwent fasting blood glucose at 24-28 weeksof gestation, regardless of results of fasting blood glucose on next visit they underwent 100g oral glucose tolerance test (OGTT). The agreementbetween fasting blood glucose and 100g oral glucose tolerance test was calculated in frequency and percentages. Results: The mean age ofwomen in studied population was 27.15±3.70.Out of 135 patients 86.7 %( 117) showed agreement between results of fasting blood glucose and100g OGTT while 13.31 %( 18) showed no agreement between both of the tests. Conclusions: Fasting blood glucose is a good screeningoption for gestational diabetes mellitus along with positive history. It provides a simple, cheap and more practical test for screening of gestationaldiabetes mellitus. However diagnostic confirmation with 100g OGTT should be done.

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 High Prevalence of Gestational Diabetes Mellitus in Rural Tanzania—Diagnosis Mainly Based on Fasting Blood Glucose from Oral Glucose Tolerance Test

2020 ◽  
Vol 17 (9) ◽  
pp. 3109 ◽  
Author(s):  
Louise Groth Grunnet ◽  
Line Hjort ◽  
Daniel Thomas Minja ◽  
Omari Abdul Msemo ◽  
Sofie Lykke Møller ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Tolerance Test ◽  
Fasting Blood Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Rural Tanzania ◽  
High Prevalence

Gestational diabetes mellitus (GDM) is associated with poor pregnancy outcomes and increased long-term risk of metabolic diseases for both mother and child. In Tanzania, GDM prevalence increased from 0% in 1991 to 19.5% in 2016. Anaemia has been proposed to precipitate the pathogenesis of GDM. We aimed to examine the prevalence of GDM in a rural area of Tanzania with a high prevalence of anaemia and to examine a potential association between haemoglobin concentration and blood glucose during pregnancy. The participants were included in a population-based preconception, pregnancy and birth cohort study. In total, 538 women were followed during pregnancy and scheduled for an oral glucose tolerance test (OGTT) at week 32–34 of gestation. Gestational diabetes mellitus was diagnosed according to the WHO 2013 guidelines. Out of 392 women screened, 39% (95% CI: 34.2–44.1) had GDM, the majority of whom (94.1%) were diagnosed based solely on the fasting blood sample from the OGTT. No associations were observed between haemoglobin or ferritin and glucose measurements during pregnancy. A very high prevalence of GDM was found in rural Tanzania. In view of the laborious, costly and inconvenient OGTT, alternative methods such as fasting blood glucose should be considered when screening for GDM in low- and middle-income countries.

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 Diagnosis of Dysglycemia in Diabetic Patients in Primary Health Care

2021 ◽  
pp. 14-19
Author(s):  
Mohammed Ibrahim Habadi ◽  
Muslima Muaidh Alrashidi ◽  
Ibrahiem Fahad Mutaki ◽  
Khaznah Awad Alshammari ◽  
Jawaher Hussain Alothayqi ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Fasting Blood Glucose ◽  
Challenge Test ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Advantages And Disadvantages ◽  
Glucose Challenge

An early diagnosis of diabetes is a cornerstone for achieving the best prognostic outcomes. The potential complications take time to develop. For this reason, diabetic patients, especially type 2 are usually diagnosed with the disease after complications have been arisen. Dysglycemia is a term that has been used to describe the fluctuations in the plasma glucose levels, including the high (hyperglycemia) and low (hypoglycemia) levels, and can also refer to impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Many modalities have been developed to assess plasma glucose levels. Studies have shown that advantages and disadvantages are reported for each modality when assessing dysglycemia and screening for diabetes. The aim of this review is to discuss the previously reported diagnostic approaches of dysglycemia among diabetic patients according to the existing published studies in the literature. The study is related to the following: the 50-g oral glucose challenge test, HbA1c, fasting blood glucose, random blood sugar, and oral glucose tolerance tests in the assessment of the blood glucose fluctuating levels. Based on the findings, it is recommended that HbA1c levels assessment should be simultaneously conducted with the random and fasting blood glucose tests to decide which patients are required to perform an OGTT. Moreover, HbA1c tests might not be affordable in some healthcare settings although they are important indicators of long-term glycemic control.

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.

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