Criteria for screening and diagnosis of gestational diabetes mellitus in the first trimester of pregnancy.

Abstract:

OBJECTIVE:To propose new cutoffs in plasma glucose levels in screening and diagnosis of gestational diabetes mellitus (GDM) in the first trimester of pregnancy. METHODS:A 50-gram oral glucose challenge test (GCT) was performed in 1,716 singleton pregnancies at 6-14 weeks' gestation. In those with a positive GCT, a 100-gram glucose tolerance test (GTT) was carried out. The GCT and as necessary the GTT were repeated at 20-30 weeks. The relation of the results of the GCT and GTT at 6-14 weeks to that at 20-30 weeks was examined. RESULTS:The diagnosis of GDM was made in 85 cases. In the GCT, there was a significant association between 1-hour plasma glucose levels at 6-14 weeks and at 20-30 weeks (r = 0.558, p < 0.0001), and in all cases of GDM, the level was 130 mg/dl or more at 6-14 weeks and 140 mg/dl or more at 20-30 weeks. In the GTT, the plasma glucose 1, 2 and 3 h after the 100-gram glucose load at 6-14 weeks was, respectively, 18, 29 and 35% lower than at 20-30 weeks. CONCLUSION:Effective diagnosis of GDM in the first trimester can be achieved by lowering the GCT and GTT plasma glucose cutoffs.

journal_name

Fetal Diagn Ther

authors

Plasencia W,Garcia R,Pereira S,Akolekar R,Nicolaides KH

doi

10.1159/000324684

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

108-15

issue

2

eissn

1015-3837

issn

1421-9964

pii

000324684

journal_volume

30

pub_type

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