Diagnostic criteria for gestational diabetes in relation to pregnancy outcome

Sereday, Martha S. de; Damiano, M; González, Claudio; Bennett, Peter H.

doi:10.1016/s1056-8727(02)00173-3

Cited by 37 publications

(17 citation statements)

References 7 publications

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“…Perucchini et al (22) found the results in favor of the fasting glucose measurement, whereas Rey et al (23) showed the 50-g glucose challenge test to be superior. Other studies investigating the test characteristics of the glucose challenge test reported sensitivities ranging from 58 to 80% (24,25) for a specificity of ϳ65% (25). In these studies, thresholds for an abnormal result of the challenge test ranged from 7.2 to 7.8 mmol/l.…”

Section: Discussionmentioning

confidence: 96%

Comparison of Accuracy Measures of Two Screening Tests for Gestational Diabetes Mellitus

Leeuwen¹,

Zweers

Opmeer

et al. 2007

Diabetes Care

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OBJECTIVE -To compare the accuracy measures of the random glucose test and the 50-g glucose challenge test as screening tests for gestational diabetes mellitus (GDM).RESEARCH DESIGN AND METHODS -In this prospective cohort study, pregnant women without preexisting diabetes in two perinatal centers in the Netherlands underwent a random glucose test and a 50-g glucose challenge test between 24 and 28 weeks of gestation. If one of the screening tests exceeded predefined threshold values, the 75-g oral glucose tolerance test (OGTT) was performed within 1 week. Furthermore, the OGTT was performed in a random sample of women in whom both screening tests were normal. GDM was considered present when the OGTT (reference test) exceeded predefined threshold values. Receiver operating characteristic (ROC) analysis was used to evaluate the performance of the two screening tests. The results were corrected for verification bias.RESULTS -We included 1,301 women. The OGTT was performed in 322 women. After correction for verification bias, the random glucose test showed an area under the ROC curve of 0.69 (95% CI 0.61-0.78), whereas the glucose challenge test had an area under the curve of 0.88 (0.83-0.93). There was a significant difference in area under the curve of the two tests of 0.19 (0.11-0.27) in favor of the 50-g glucose challenge test.CONCLUSIONS -In screening for GDM, the 50-g glucose challenge test is more useful than the random glucose test. Diabetes Care 30:2779-2784, 2007G estational diabetes mellitus (GDM) is estimated to occur in 2-9% of all pregnancies (1-5). It is defined as carbohydrate intolerance with onset or first recognition during pregnancy and is associated with increased rates of adverse pregnancy outcomes, such as macrosomia; shoulder dystocia; birth-related trauma, such as fractures and nerve palsies; neonatal hypoglycemia; and jaundice. In addition, women with GDM are at substantially higher risk to develop diabetes in later life (1,6 -8). Results from a randomized controlled trial show that treatment of GDM by means of dietary advice, blood glucose monitoring, and insulin therapy, if required, reduces the rate of serious perinatal complications without increasing the rate of caesarean delivery (1). Based on these results, identification through screening and subsequent treatment of women with GDM appears beneficial. However, consensus on the optimal policy for screening is lacking. The American Diabetes Association recommends screening based on risk factors for GDM (age Ͼ25 years, obese, close relative with diabetes, history of GDM or a previous macrosomic infant, or specific ethnicity) followed by the 50-g 1-h oral glucose challenge test as a screening test (9 -11). Other methods of screening that are regularly used are (repeated) random glucose testing and fasting glucose measurement. It is indefinite which test is the most accurate in testing women for GDM.The diversity in screening methods may result in unidentified cases of GDM and preventable neonatal and maternal morbidity. Establishment of ...

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Section: Discussionmentioning

confidence: 96%

Comparison of Accuracy Measures of Two Screening Tests for Gestational Diabetes Mellitus

Leeuwen¹,

Zweers

Opmeer

et al. 2007

Diabetes Care

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“…De Serday et al determined in a study on 473 pregnant women that 137 mg/dl to be the most convenient cut-off value for 1-hour GCT. They found the optimal sensitivity for the 1-hour 50-g test screening at this value as 66.7% (24).…”

Section: Discussionmentioning

confidence: 91%

50 G Glukoz Yükleme Testinin Gestasyonel Diyabet Tanısındaki Etkinliği

İnan¹,

Ağır²,

Sağır³

2014

Haseki

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ÖzetAmaç: Bu çalışmada amacımız, 50 g glukoz challenge test (GCT) ile açlık kan glukoz değerlerinin gestasyonel diyabet (GDM) tanısında etkinliğini araştırmak, tarama için bir cut-off değeri belirlemektir. Yöntemler: Dörtyüz kırk dört gebeye 24-28 gestasyonel haftaları arasında 50 gr GCT uygulandı. Gestasyonel diyabet hastalarını atlamamak için eşik değer 130 mg/dl olarak alındı. Plazma glukoz düzeyinin birinci saatte 130 mg/dl ve üzerindeki sonuçlar pozitif olarak kabul edildi ve bu gebelere 100 gr oral glukoz tolerans testi (OGTT) uygulandı. Bulgular: 50 g GCT için cut-off değeri 145 mg/dl olarak bulundu. 145 mg/dl ve üzerindeki değerlerde testin GDM'yi öngörmede duyarlılık %96,30; özgüllük %80,34 olarak belirlendi. Açlık kan glukoz cut-off değeri için belirlenen 88 mg/dl'da duyarlılığın % 48,15 özgüllüğün %70,84 olduğu bulundu. Sonuç: Özellikle 50 g GCT'de birinci saat kan glukoz değeri 145mg/dl ve üzerindeki değerlerde gestasyonel diyabet tanısı koymada etkiniliğin arttığı , açlık kan glukoz düzeyinin GDM için iyi bir tarama testi olamayacağı sonucuna varıldı. Abs tractAim: Our aim in this study was to investigate the efficacy of 50 g glucose challenge test (GCT) in the diagnosis of gestational diabetes mellitus (GDM) and to determine a cut-off value for screening. Methods: 50-g GCT was performed in 444 pregnant women at 24-28 gestational weeks. The threshold was taken as 130 mg/dl in order not to miss GDM cases. A plasma glucose level of ≥130 mg/ dl at the first hour was considered to be a positive result and 100-g oral glucose tolerance test (OGTT) was given to these women. Results: The cut-off value for 50-g GCT was found to be 145 mg/ dl. The sensitivity and specificity of the test for predicting GDM at the levels of ≥145 mg/dl were determined to be 96.30% and 80.34%, respectively. The sensitivity and specificity of the test at the level of 88 mg/dl determined for fasting blood glucose cut-off value were found to be 48.15% and 70.84%, respectively. Conclusion: It was concluded that the efficacy in making diagnosis of GDM was increased at the first hour blood glucose levels of ≥145 mg/dl, especially in 50-g GCT, and fasting blood glucose level could not be a good screening test for GDM. (The Me di cal Bul le tin of Ha se ki 2014; 52: 181-6)

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“…De Sereday et al (32) compared GDM screening according to WHO criteria with the ADA two-step procedure (GCT followed by a 3-h 100-g glucose OGTT). The WHO criteria were able to predict the development of macrosomia with higher sensitivity compared to the ADA criteria, which in turn provided higher specificity and predictive values.…”

Section: Discussionmentioning

confidence: 99%

National survey on the execution of the oral glucose tolerance test (OGTT) in a representative cohort of Italian laboratories

Federici¹,

Mosca²,

Testa³

et al. 2006

Clinical Chemistry and Laboratory Medicine (CCLM)

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For the Italian laboratories investigated, relevant variability was highlighted for performance of the OGTT in general and GDM screening in particular. A variable relationship between laboratories and diabetes centres was also detected, which might represent a relevant indicator for the need for rationalisation or standardisation of the method for performing an OGTT. These data highlight the need for greater collaboration between these different bodies. We suggest that other similar investigations should be carried out in other countries within the framework of the IFCC Global Campaign on Diabetes Mellitus.

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Diagnostic criteria for gestational diabetes in relation to pregnancy outcome

Cited by 37 publications

References 7 publications

Comparison of Accuracy Measures of Two Screening Tests for Gestational Diabetes Mellitus

Comparison of Accuracy Measures of Two Screening Tests for Gestational Diabetes Mellitus

50 G Glukoz Yükleme Testinin Gestasyonel Diyabet Tanısındaki Etkinliği

National survey on the execution of the oral glucose tolerance test (OGTT) in a representative cohort of Italian laboratories

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