Fasting Plasma Glucose at 24–28 Weeks to Screen for Gestational Diabetes Mellitus

Zhu, Wenzhen; Liu, Fan; Yang, Huixia; Kong, Ling Ying; Su, Shi ping; Wang, Zilian; Hu, Yali; Zhang, Meihua; Sun, Li; Mi, Yang; Du, Xiu Ping; Zhang, Hua; Wang, Yunhui; Huang, Ying; Zhong, Li-ruo; Wu, Haiyan; Li, Nan; Wang, Yunfeng; Kapur, Anil

doi:10.2337/dc12-2465

Cited by 85 publications

(63 citation statements)

References 9 publications

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“…The positive predictive value was 0.322, and the negative predictive value was 0.928. 13 In our present study FPG cut off value of 5.1mmol/L identified 48 (11.5 %) pregnant women with GDM. The positive predictive value is 0.289, and the negative predictive value is 0.958 and is similar to the study by Zhu et al 13 Women with FPG values between 4.4 and 5.1mmol/L require a 75-g 2-h OGTT to confirm or rule out GDM.…”

Section: Discussionsupporting

confidence: 51%

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Utility of fasting plasma glucose test as screening tool for gestational diabetes mellitus based on International Association of the Diabetes and Pregnancy Study Group criteria

Sharma

Agrawal

Goel

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionsupporting

confidence: 51%

“…13 In their study FPG cut off value of 5.1 mmol/L identified 12.1% pregnant women with GDM. FPG cut off value of 4.4 mmol/L ruled out GDM in 38.2% women.…”

Section: Discussionmentioning

confidence: 94%

Utility of fasting plasma glucose test as screening tool for gestational diabetes mellitus based on International Association of the Diabetes and Pregnancy Study Group criteria

Sharma

Agrawal

Goel

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…An FPG result ≤4.4 mmol/l has been associated with low risk and suggested as a potential screening test in the IADPSG recommendations [7]. A high negative predictive value of this screening test has been described in Middle Eastern and Chinese populations, but has not been addressed in European pregnant women [45,46]. Other screening strategies using the new WHO diagnostic criteria, such as a twostep screening strategy with a 50 g GCT followed by a 75 g OGTT if the GCT is abnormal, or selective screening according to risk factors, should also be evaluated prospectively in European populations.…”

Section: Risk Factors For Diabetes and Gdm • Previous Gestational Diamentioning

confidence: 99%

A proposal for the use of uniform diagnostic criteria for gestational diabetes in Europe: an opinion paper by the European Board & College of Obstetrics and Gynaecology (EBCOG)

et al. 2015

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Screening and diagnostic criteria for gestational diabetes (GDM) are inconsistent across Europe, and the development of a uniform GDM screening strategy is necessary. Such a strategy would create opportunities for more women to receive timely treatment for GDM. Developing a consensus on screening for GDM in Europe is challenging, as populations are diverse and healthcare delivery systems also differ. The European Board & College of Obstetrics and Gynaecology (EBCOG) has responded to this challenge by appointing a steering committee, including members of the EBCOG and the Diabetic Pregnancy Study Group (DPSG) associated with the EASD, to develop a proposal for the use of uniform diagnostic criteria for GDM in Europe. A proposal has been developed and has now been approved by the Council of the EBCOG. The current proposal is to screen for overt diabetes at the first prenatal contact using cut-off values for diabetes outside pregnancy, with particular efforts made to screen high-risk groups. When screening for GDM is performed at 24 weeks' gestation or later, the proposal is now to use the 75 g OGTT with the new WHO diagnostic criteria for GDM. However, more research is necessary to evaluate the best GDM screening strategy for different populations in Europe. Therefore, no clear recommendation has been made on whether a universal one-step, two-step or a risk-factorbased screening approach should be used. The use of the same WHO diagnostic GDM criteria across Europe will be an important step towards uniformity.

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“…Our approach was similar to that of several studies designed with the aim to identify the best diagnostic approach for GDM (19,20,21,22,23). In the European countries, the nonconformity of screening and diagnostic procedures for GDM is responsible for the different reported prevalence rates of GDM (6).…”

Section: Discussionmentioning

confidence: 80%

Improvement of selective screening strategy for gestational diabetes through a more accurate definition of high-risk groups

Pintaudi

Vieste

Corrado

et al. 2014

European Journal of Endocrinology

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Objective: This study aimed to assess the predictive value of risk factors (RFs) for gestational diabetes mellitus (GDM) established by selective screening (SS) and to identify subgroups of women at a higher risk of developing GDM. Design: A retrospective, single-center study design was employed. Methods: Data of 1015 women screened for GDM at 24-28 weeks of gestation and diagnosed according to the International Association of Diabetes and Pregnancy Study Groups criteria were evaluated. Information on RFs established by SS was also collected and their association with GDM was determined. To identify distinct and homogeneous subgroups of patients at a higher risk, the RECursive Partitioning and AMalgamation (RECPAM) method was used. Results: Overall, 113 (11.1%) women were diagnosed as having GDM. The application of the SS criteria would result in the execution of an oral glucose tolerance test (OGTT) in 58.3% of women and 26 (23.0%) cases of GDM would not be detected due to the absence of any RF. The RECPAM analysis identified high-risk subgroups characterized by fasting plasma glucose values O5.1 mmol/l (odds ratio (OR)Z26.5; 95% CI 14.3-49.0) and pre-pregnancy BMI (ORZ7.0; 95% CI 3.9-12.8 for overweight women). In a final logistic model including RECPAM classes, previous macrosomia (ORZ3.6; 95% CI 1.1-11.6), and family history of diabetes (ORZ1.8; 95% CI 1.1-2.8), but not maternal age, were also found to be associated with an increased risk of developing GDM. A screening approach based on the RECPAM model would reduce by over 50% (23.0 vs 10.6%) the number of undiagnosed GDM cases when compared with the current SS approach, at the expense of 50 additional OGTTs required. Conclusions: A screening approach based on our RECPAM model results in a significant reduction in the number of undetected GDM cases compared with the current SS procedure.

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Fasting Plasma Glucose at 24–28 Weeks to Screen for Gestational Diabetes Mellitus

Cited by 85 publications

References 9 publications

Utility of fasting plasma glucose test as screening tool for gestational diabetes mellitus based on International Association of the Diabetes and Pregnancy Study Group criteria

Utility of fasting plasma glucose test as screening tool for gestational diabetes mellitus based on International Association of the Diabetes and Pregnancy Study Group criteria

A proposal for the use of uniform diagnostic criteria for gestational diabetes in Europe: an opinion paper by the European Board & College of Obstetrics and Gynaecology (EBCOG)

Improvement of selective screening strategy for gestational diabetes through a more accurate definition of high-risk groups

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