Glucose challenge testing in pregnancy

Article Abstract:

Gestational diabetes is diabetes that occurs during pregnancy. Diabetes can be diagnosed by measuring the amount of glucose (sugar) present in the blood after a meal and by measuring the amount of sugar in the blood after drinking a solution containing large amounts of glucose, the glucose tolerance test (GTT). Those with diabetes will have high levels of sugar in their blood following a meal and following GTT. To determine if the results of glucose testing for diabetes are related to the outcome of the pregnancy, 608 pregnant women were studied. Eighty-eight of the women had abnormally high glucose levels detected by glucose screening. When GTTs were performed, 35 of the women had higher than normal levels of blood glucose (an abnormal GTT), and 48 had normal GTT. The mean infant birth weight and the incidence of infant morbidity and maternal morbidity were the same for those with normal GTTs and those who had abnormal GTTs. There was no relationship between the results of the GTTs and the incidence of birth trauma, cesarean delivery, or fetal macrosomia (oversized body). These findings indicate that the results of glucose testing had little relationship to the outcome of these pregnancies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical examination, Pregnant women

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Gestational diabetes diagnostic criteria: long-term maternal follow-up

Article Abstract:

Coustan's diagnostic criteria for gestational diabetes are recommended over those of the National Diabetes Data Group (NDDG) because Coustan's lower thresholds identify more women with gestational diabetes. Pregnant women with diabetes have a much higher risk of developing glucose metabolism abnormalities later in life. Between 1988 and 1990, a group of 331 women who had undergone glucose tolerance testing since 1975 had a history taken or underwent a 2-hour 75 g glucose tolerance test. There were 190 women who were gestational diabetics by NDDG standards and an additional 141 women who would be considered gestational diabetics according to Coustan's lower thresholds. Coustan's values identify 69% more women as gestational diabetics. One-quarter of both these groups had abnormal results on the follow-up glucose tolerance test. Risk factors for abnormal glucose tolerance were glucose tolerance test fasting value, number of pregnancies with gestational diabetes, time to follow up, and prepregnancy weight. Risk factors also did not differ between the two groups.

Risk factors, Diabetes, Diabetes mellitus

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Which cutoff level should be used in screening for glucose intolerance in pregnancy?

Article Abstract:

Lowering the threshold for diagnosing gestational diabetes needs to be balanced against the costs of screening more women and the higher rate of false positives. Researchers analyzed glucose tolerance tests performed on 704 pregnant women. Using various thresholds, they found that a cutoff of 140 milligrams per deciliter would identify women with definite glucose intolerance. Lowering the cutoff value would identify women with borderline glucose intolerance, but this increased effort may not be cost-effective.

Standards, Economic aspects, Medical screening, Health screening

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