Background and aims: Gestational diabetes is defined as 'carbohydrate intolerance first recognised in pregnancy'. The definition encompasses women diagnosed in early pregnancy. Concerns exist that such cases phenotypically resemble those with established pre-existing diabetes and therefore have a higher risk profile. We aim to evaluate women diagnosed with impaired carbohydrate intolerance in early pregnancy and compare them with those with established Type 2 diabetes and gestational diabetes diagnosed on routine screening (24À28 weeks' gestation). Methods: We retrospectively reviewed 84 women who attended our inner-city conjoint antenatal clinic (2009À2012). Baseline demographics, insulin therapy requirement and outcomes were compared in women with gestational diabetes diagnosed prior to routine screening (group 1, n = 18) and women with established Type 2 diabetes (group 2, n = 66). A separate cohort of age-matched controls with routinely diagnosed gestational diabetes was identified (group 3, n = 18). Results: Mean age (groups 1À3, 35.6 years, 32.6 years, 35.4 years respectively) and proportion of women originating from non-Caucasian ethnicities (72%, 74%, 78%) were similar across the groups. Women were significantly more likely to be multiparous in group 1 (85%, 15%, 13.6%). Mean booking body mass index (BMI) in groups 1 and 2 were similar: group 1 had a significantly higher booking BMI than group 3 (32.3kg/m 2 ; 30.4kg/m 2 ; 28.3kg/ m 2 ). Differences in HbA1c at booking/diagnosis displayed similar patterns [group 1, 61.4mmol/mol; group 2, 58.5mmol/mol (p = ns); group 3, 38.3mmol/mol (p < 0.005)], as did requirement for insulin therapy [group 1, 94%; group 2, 83.3% (p = ns); group 3, 27.8% (p = 0.04)]. Unplanned Caesarean section rates (33.3%, 28.8%, 38.9%), mean fetal birth weight (3,402g AE 767; 3,257g AE 690; 3,218g AE 503) and birth weight centile (60 AE 37; 59 AE 36; 45 AE 25) were similar across the groups. A higher proportion of infants were born large for gestational age in group 1 and group 2 (27.8%, 25.8%, 5.6%; p = ns). Conclusions: Our analysis has demonstrated that women with carbohydrate intolerance diagnosed early in pregnancy phenotypically resemble those with Type 2 diabetes both in terms of treatment required and outcomes. The role of HbA1c at booking could be investigated as a potential screening tool. A34 (P394)Fasting plasma glucose (FPG) alone will miss persisting postnatal glucose abnormalities in gestational diabetes Aims: To assess the utility of FPG in detecting persisting postnatal hyperglycaemia in gestational diabetes.Methods: Retrospective data were collected for all antenatal and postnatal oral glucose tolerance tests (OGTT) between January 2008 and 2013 across three centres in the West Midlands that used selective screening and WHO criteria. A descriptive study was undertaken comparing the utility of OGTT and FPG postnatally. Results: In all, 14,360 women were screened antenatally; 1,289 women had gestational diabetes and 632 (49%) had OGTT (mean AE SD: 9.4 AE 4.1 weeks). Mean...

(Abstracted from J Matern Fetal Neonatal Med 2020;33:3977–3983) Gestational diabetes mellitus (GDM) is defined as diabetes in pregnancy during the second or third trimester that is not overtly preexisting diabetes mellitus (DM). The time frame during gestation is based on the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study, which showed an association between glucose and infants born large for gestational age in women who took a 75-g oral glucose tolerance test (OGTT) at routine testing (24–48 weeks' gestation).

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