scholarly journals Early Screening for Gestational Diabetes Using IADPSG Criteria May Be a Useful Predictor for Congenital Anomalies: Preliminary Data from a High-Risk Population

2020 ◽  
Vol 9 (11) ◽  
pp. 3553
Author(s):  
Agnieszka Zawiejska ◽  
Katarzyna Wróblewska-Seniuk ◽  
Paweł Gutaj ◽  
Urszula Mantaj ◽  
Anna Gomulska ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Congenital Malformations ◽  
Fasting Blood Glucose ◽  
High Risk Population ◽  
Oral Glucose ◽  
Iadpsg Criteria ◽  
In Pregnancy

Background: Our aim was to investigate whether the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) glycemic thresholds used for detecting hyperglycemia in pregnancy can be predictive for malformations in women with hyperglycemia detected in early pregnancy. Methods: a single-center, retrospective observational trial of 125 mother-infant pairs from singleton pregnancies with hyperglycemia according to the IADPSG criteria diagnosed at the gestational age below 16 weeks. Glucose values obtained from 75-g OGTT (oral glucose tolerance test) were investigated as predictors for congenital malformations in newborns. Results: Characteristics of the cohort: maternal age: 31.5 ± 5.2, pre-pregnancy body mass index (BMI) ≥ 30 kg/m2: 42.0%, gestational age at diagnosis (weeks): 12.0 ± 4.0, and newborns with congenital malformations: 8.8%. Fasting blood glycemia (FBG) and HbA1c (Haemoglobin A1c) at baseline significantly predicted the outcome (expB: 1.06 (1.02–1.1), p = 0.007 and expB: 2.05 (1.24–3.38), p = 0.005, respectively). Both the fasting blood glucose (FBG) value of 5.1 mmol/dL (diagnostic for gestational diabetes mellitus (GDM)) and 5.5 mmol/dL (upper limit for normoglycemia in the general population) significantly increased the likelihood ratio (LR) for fetal malformations: 1.3 (1.1; 1.4) and 1.5 (1.0; 2.4), respectively. Conclusions: (1) Fasting glycemia diagnostic for GDM measured in early pregnancy is associated with a significantly elevated risk for congenital malformations. (2) Our data suggest that women at elevated risks of GDM/diabetes in pregnancy (DiP) should have their fasting blood glucose assessed before becoming pregnant, and the optimization of glycemic control should be considered if the FBG exceeds 5.1 mmol/dL.

scholarly journals Development of a fasting blood glucose-based strategy to diagnose women with gestational diabetes mellitus at increased risk of adverse outcomes in a COVID-19 environment

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243192
Author(s):  
Michael d’Emden ◽  
Donald McLeod ◽  
Jacobus Ungerer ◽  
Charles Appleton ◽  
David Kanowski
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Adverse Outcomes ◽  
Oral Glucose ◽  
Increased Risk ◽  
In Pregnancy

Objective To evaluate the role of fasting blood glucose (FBG) to minimise the use of the oral glucose tolerance test in pregnancy (POGTT) for the diagnosis of gestational diabetes mellitus (GDM). Research design and methods We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30 June 2015. A receiver operator characteristics (ROC) assessment was undertaken to indicate the FBG level that most effectively identified women at low risk of an abnormal result. Results There were 3,946 (15.0%) patients having GDM with 2,262 (8.6%) having FBG ≥ 5.1mmol/l. The ROC identified FBG levels >4.6mmol/l having the best specificity (77%) and sensitivity (54%) for elevated 1 and/or 2hr BGLs. There were 19,321 (73.7%) women having FBG < 4.7mmol/l with a prevalence of GDM of 4.0%, less than 1/3rd the overall rate. Only 4,638 (17.7%) women having FBGs from 4.7–5.0mmol/l would require further evaluation to confirm or exclude the diagnosis. Conclusion This contemporary study of women across the state of Queensland, Australia suggests the FBG can be used effectively to define glucose tolerance in pregnancy, minimising their contact with pathology laboratories and potential exposure to the corona virus. This analysis, used in conjunction with outcome data from the HAPO study, provides reassurance to women and their health professionals that FBG < 4.7mmol/l has both a low rate of abnormal glucose tolerance and minimal adverse pregnancy-associated complications.

scholarly journals High probability of false-positive gestational diabetes mellitus diagnosis during early pregnancy

2020 ◽  
Vol 8 (1) ◽  
pp. e001234
Author(s):  
Sayuri Nakanishi ◽  
Shigeru Aoki ◽  
Junko Kasai ◽  
Ryosuke Shindo ◽  
Soichiro Obata ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Therapeutic Intervention ◽  
False Positive ◽  
Early Onset ◽  
Oral Glucose ◽  
Study Cohort ◽  
Iadpsg Criteria

IntroductionThis study aimed to assess the validity of applying the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) at any time during pregnancy.Research design and methodsThis multicenter cohort study was conducted at five Japanese facilities from January 2018 to April 2019. The study cohort included women at a high risk of GDM who met one or more of the following IADPSG criteria during early pregnancy: fasting plasma glucose (FPG) ≥92 mg/dL and 75 g oral glucose tolerance test (OGTT) value of ≥180 mg/dL at 1 hour, or ≥153 mg/dL at 2 hour (hereafter early-onset GDM). Women diagnosed with early-onset GDM were followed up without therapeutic intervention and underwent the 75 g OGTT again during 24–28 weeks of gestation. Those exhibiting the GDM patterns on the second 75 g OGTT were diagnosed with true GDM and treated, whereas those exhibiting the normal patterns were diagnosed with false positive early GDM and received no therapeutic intervention.ResultsOf the 146 women diagnosed with early-onset GDM, 69 (47%) had normal 75 g OGTT values at 24–28 weeks of gestation, indicating a false-positive result. FPG levels were significantly higher in the first 75 g-OGTT test than in the second 75 g-OGTT test (93 mg/dL and 87.5 mg/dL, respectively; p<0.001). FPG levels were high in 86 (59%) women with early-onset GDM during early pregnancy but in only 39 (27%) women during mid-pregnancy. Compared with false positive early GDM, true GDM was more frequently associated with adverse pregnancy outcomes.ConclusionsAlthough women with early-onset GDM were followed up without treatment, the results of repeated 75 g OGTT during mid-pregnancy were normal in about 50%. Our data did not support the adoption of IADPSG thresholds for the diagnosis of GDM prior to 20 weeks of gestation.

scholarly journals GESTATIONAL DIABETES MELLITUS

2012 ◽  
Vol 19 (04) ◽  
pp. 462-468
Author(s):  
M. IKRAM ◽  
SYED HAIDER HASAN ALAM ◽  
SHAFQAT MUKHTAR ◽  
M. Saeed
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Glucose Tolerance Test ◽  
Fasting Blood Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Introduction: Gestational diabetes mellitus is common disorder in pregnancy. It is associated with adverse pregnancy outcome. There is no consensus regarding the optimal approach to screening of gestational diabetes mellitus. The present study has tried toobserve the value of fasting blood glucose in screening of gestational diabetes. Objective: To determine the frequency of patients in whomfasting blood glucose and 100gm glucose tolerance show agreement for screening of gestational diabetes mellitus at 24 -28 wks. Studydesign: Comparative cross sectional study. Settings: The study was conducted at Gynecology and Obstetrics department Shaikh ZayedFederal Post Graduate Institute Lahore. Duration of study with dates: 6 months from 12Nov 2010 to 11 May 2011. Material and method: Thestudy included 135 booked patients with positive family history of diabetes mellitus. All patients underwent fasting blood glucose at 24-28 weeksof gestation, regardless of results of fasting blood glucose on next visit they underwent 100g oral glucose tolerance test (OGTT). The agreementbetween fasting blood glucose and 100g oral glucose tolerance test was calculated in frequency and percentages. Results: The mean age ofwomen in studied population was 27.15±3.70.Out of 135 patients 86.7 %( 117) showed agreement between results of fasting blood glucose and100g OGTT while 13.31 %( 18) showed no agreement between both of the tests. Conclusions: Fasting blood glucose is a good screeningoption for gestational diabetes mellitus along with positive history. It provides a simple, cheap and more practical test for screening of gestationaldiabetes mellitus. However diagnostic confirmation with 100g OGTT should be done.

scholarly journals Secretagogin is Related to Insulin Secretion but Unrelated to Gestational Diabetes Mellitus Status in Pregnancy

2020 ◽  
Vol 9 (7) ◽  
pp. 2277
Author(s):  
Carola Deischinger ◽  
Jürgen Harreiter ◽  
Karoline Leitner ◽  
Dagmar Bancher-Todesca ◽  
Sabina Baumgartner-Parzer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Secretion ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Gestational Diabetes Mellitus ◽  
Plasma Concentrations ◽  
High Risk Population ◽  
Oral Glucose ◽  
Second Phase ◽  
In Pregnancy

Secretagogin (SCGN) is a calcium binding protein related to insulin release in the pancreas. Although SCGN is not co-released with insulin, plasma concentrations have been found to be increased in type 2 diabetes mellitus patients. Until now, no study on SCGN levels in pregnancy or patients with gestational diabetes mellitus (GDM) has been published. In 93 women of a high-risk population for GDM at the Medical University of Vienna, secretagogin levels of 45 GDM patients were compared to 48 women with a normal glucose tolerance (NGT). Glucose tolerance, insulin resistance and secretion were assessed with oral glucose tolerance tests (OGTT) between the 10th and 28th week of gestation (GW) and postpartum. In all women, however, predominantly in women with NGT, there was a significant positive correlation between SCGN levels and Stumvoll first (rp = 0.220, p = 0.032) and second phase index (rp = 0.224, p = 0.028). SCGN levels were not significantly different in women with NGT and GDM. However, SCGN was higher postpartum than during pregnancy (postpartum: 88.07 ± 35.63 pg/mL; pregnancy: 75.24 ± 37.90 pg/mL, p = 0.004). SCGN was directly correlated with week of gestation (rp = 0.308; p = 0.021) and triglycerides (rp = 0.276; p = 0.038) in women with GDM. Therefore, SCGN is related to insulin secretion and hyperinsulinemia during pregnancy; however, it does not display differences between women with NGT and GDM.

scholarly journals The Role of Untimed Blood Glucose in Screening for Gestational Diabetes Mellitus in a High Prevalent Diabetic Population

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sarah Cuschieri ◽  
Johann Craus ◽  
Charles Savona-Ventura
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Fasting Blood Glucose ◽  
Diabetes Type 2 ◽  
Obstetric Outcomes ◽  
Oral Glucose ◽  
Stepwise Logistic Regression ◽  
Operating Characteristics ◽  
Screening Protocol

Global prevalence increase of diabetes type 2 and gestational diabetes (GDM) has led to increased awareness and screening of pregnant women for GDM. Ideally screening for GDM should be done by an oral glucose tolerance test (oGTT), which is laborious and time consuming. A randomized glucose test incorporated with anthropomorphic characteristics may be an appropriate cost-effective combined clinical and biochemical screening protocol for clinical practice as well as cutting down on oGTTs. A retrospective observational study was performed on a randomized sample of pregnant women who required an OGTT during their pregnancy. Biochemical and anthropomorphic data along with obstetric outcomes were statistically analyzed. Backward stepwise logistic regression and receiver operating characteristics curves were used to obtain a suitable predictor for GDM without an oGTT and formulate a screening protocol. Significant GDM predictive variables were fasting blood glucose (p=0.0001) and random blood glucose (p=0.012). Different RBG and FBG cutoff points with anthropomorphic characteristics were compared to carbohydrate metabolic status to diagnose GDM without oGTT, leading to a screening protocol. A screening protocol incorporating IADPSG diagnostic criteria, BMI, and different RBG and FBG criteria would help predict GDM among high-risk populations earlier and reduce the need for oGTT test.

scholarly journals Lactobacillus bulgaricus improves antioxidant capacity of black garlic in the prevention of gestational diabetes mellitus: a randomized control trial

2019 ◽  
Vol 39 (8) ◽  
Author(s):  
Lihui Si ◽  
Ruixin Lin ◽  
Yan Jia ◽  
Wenwen Jian ◽  
Qing Yu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Antioxidant Capacity ◽  
Controlled Trial ◽  
Fasting Blood Glucose ◽  
Lactobacillus Bulgaricus ◽  
Oral Glucose ◽  
13C Nuclear Magnetic Resonance

AbstractObjectives: Lactobacillus bulgaricus may improve antioxidant capacity of black garlic in the prevention of gestational diabetes mellitus (GDM).Methods: Black garlic was prepared with or without L. bulgaricus. Volatile and polysaccharides were analyzed by using LC-MS, Fourier Transform infrared (FTIR) and 13C nuclear magnetic resonance (NMR). The study design was parallel randomized controlled trial and 226 GDM patients were randomly assigned into BG (black garlic and L. bulgaricus) and CG (black garlic) groups, and allocation ratio was 1:1. The treatment duration was 40 weeks. Fasting blood glucose (FBG) and 1- and 2-h blood glucose (1hBG and 2hBG) after oral glucose tolerance test (OGTT) were detected. Antioxidant function of black garlic was determined by measuring plasma malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX) and total antioxidant capacity (T-AOC) in GDM patients. The comparison between two groups was made using two independent samples t test.Results: The intake of nutrients was similar between two groups (P>0.05). L. bulgaricus promoted the transformation of the glucopyranoside to glucofuranoside. L. bulgaricus increased the abilities of black garlic for scavenging hydroxyl radicals, 2,2′-azino-bis (3-ethylbenzenthiazoline-6-sulfonic) acid (ABTS) and DPPH free radicals. L. bulgaricus reduced the levels of FBG, 1hBG and 2hBG, and incidence of perinatal complications (P<0.01). Plasma MDA level in the BG group was lower than in the CG group, whereas the levels of SOD, GSH-PX and T-AOC in the BG group were higher than in the CG group (P<0.01).Conclusions: L. bulgaricus improves antioxidant capacity of black garlic in the prevention of GDM.

scholarly journals Effectiveness of diabetes in pregnancy study group India diagnostic criterion in detecting gestational diabetes mellitus: a rural Bangalore study

2020 ◽  
Vol 9 (2) ◽  
pp. 601
Author(s):  
Rajiv Kumar Saxena ◽  
Noor Fathima Tameem Ansari ◽  
Pallavi Singh
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
False Negative ◽  
Oral Glucose ◽  
Study Group ◽  
Diabetes In Pregnancy ◽  
Capillary Sample ◽  
Iadpsg Criteria ◽  
Venous Sample ◽  
In Pregnancy

Background: The oral glucose tolerance test (OGTT) is considered the current standard for diagnosis of gestational diabetes mellitus (GDM). International association of diabetes and pregnancy study groups (IADPSG) recommends OGTT, with fasting, one-hour and two-hour venous blood samples drawn after intake of 75g oral glucose. In the Indian context, diabetes in pregnancy study group in India (DIPSI) recommends glucose challenge test (GCT), where 75 g glucose is given irrespective of the fasting state, and a single venous sample is drawn after two-hour. Diagnosis of GDM is made, if any cut-off value is met or exceeded. This prospective study was conducted to compare the DIPSI and IADPSG criteria for diagnosis of GDM.Methods: Pregnant women between 24 to 28 weeks of gestation were subjected to non-fasting GCT. Capillary sample were also drawn simultaneously using Accu check active glucometer. These women were counselled to undergo a standard 75gram OGTT, within a week of recruitment.Results: According to IADPSG criteria, 17.6% (18/102) of our participants had GDM, as compared to 19.6% (20/102) by DIPSI criteria using venous samples, and 25.3% (25/99) by capillary sample method. Sensitivity and specificity of GCT using venous sample was 72.22% and 91.67%, and using capillary sample was 70.59% and 84.15% respectively. DIPSI criteria using venous samples wrongly labelled 8.3% women as GDM, and capillary samples wrongly labelled 15.9% women as GDM. More importantly DIPSI criteria using venous samples labelled 27.8% women as false-negative and capillary samples labelled 29.4% women as false-negative for GDM. Almost one quarter of women with GDM will be missed if DIPSI criteria is used as a universal screening modality.Conclusions: We suggest that the IADPSG criteria be used for diagnosis of GDM in antenatal women in India.

Neonatal outcomes among offspring of obese women diagnosed with gestational diabetes mellitus in early versus late pregnancy

2018 ◽  
Vol 41 (3) ◽  
pp. 535-542 ◽  
Author(s):  
N E Grotenfelt ◽  
K Rönö ◽  
J G Eriksson ◽  
A Valkama ◽  
J Meinilä ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Late Pregnancy ◽  
Neonatal Outcomes ◽  
Large For Gestational Age ◽  
Oral Glucose ◽  
Diabetes Diagnosis ◽  
Obese Women ◽  
Diabetes Group

Abstract Background Maternal metabolic derangements associated with early pregnancy gestational diabetes may affect the fetus differently compared with gestational diabetes diagnosed later in pregnancy. The aim of this observational study was to assess neonatal outcomes according to timing of gestational diabetes diagnosis in obese women. Methods Women ≥18 years of age with a pre-pregnancy body mass index ≥30 kg/m2 were grouped according to the results of a 75 g 2-h oral glucose tolerance test performed at 13.1 weeks of gestation and repeated at 23.4 weeks if normal at first testing. The main outcomes were birthweight and large for gestational age. Results Out of 361 women, 164 (45.4%) were diagnosed with gestational diabetes, 133 (81.1%) of them in early pregnancy. The mean offspring birthweight was 3673 g (standard deviation (SD) 589 g) in the early and 3710 g (SD 552 g) in the late gestational diabetes group. In a multivariate logit model, the odds ratio for large for gestational age was 2.01 (95% CI: 0.39–10.39) in early compared with late gestational diabetes. Conclusions We observed no statistically significant differences in neonatal outcomes according to timing of gestational diabetes diagnosis. In addition to lack of power, early treatment of hyperglycemia may partly explain the results.

scholarly journals High Prevalence of Gestational Diabetes Mellitus in Rural Tanzania—Diagnosis Mainly Based on Fasting Blood Glucose from Oral Glucose Tolerance Test

2020 ◽  
Vol 17 (9) ◽  
pp. 3109 ◽  
Author(s):  
Louise Groth Grunnet ◽  
Line Hjort ◽  
Daniel Thomas Minja ◽  
Omari Abdul Msemo ◽  
Sofie Lykke Møller ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Glucose Tolerance Test ◽  
Fasting Blood Glucose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Rural Tanzania ◽  
High Prevalence

Gestational diabetes mellitus (GDM) is associated with poor pregnancy outcomes and increased long-term risk of metabolic diseases for both mother and child. In Tanzania, GDM prevalence increased from 0% in 1991 to 19.5% in 2016. Anaemia has been proposed to precipitate the pathogenesis of GDM. We aimed to examine the prevalence of GDM in a rural area of Tanzania with a high prevalence of anaemia and to examine a potential association between haemoglobin concentration and blood glucose during pregnancy. The participants were included in a population-based preconception, pregnancy and birth cohort study. In total, 538 women were followed during pregnancy and scheduled for an oral glucose tolerance test (OGTT) at week 32–34 of gestation. Gestational diabetes mellitus was diagnosed according to the WHO 2013 guidelines. Out of 392 women screened, 39% (95% CI: 34.2–44.1) had GDM, the majority of whom (94.1%) were diagnosed based solely on the fasting blood sample from the OGTT. No associations were observed between haemoglobin or ferritin and glucose measurements during pregnancy. A very high prevalence of GDM was found in rural Tanzania. In view of the laborious, costly and inconvenient OGTT, alternative methods such as fasting blood glucose should be considered when screening for GDM in low- and middle-income countries.

scholarly journals Effects of Risk Factors for Pregnancy Outcomes of Subsequent Pregnancy Associated with Gestational Diabetes Mellitus: A Retrospective Cohort Study in China.

2021 ◽  
Author(s):  
Weijiao Xu ◽  
Xia Xu ◽  
Yanni Guo ◽  
Jie Liang ◽  
Jianying Yan
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Child Outcomes ◽  
Fasting Blood Glucose ◽  
Neonatal Outcomes ◽  
Lipid Levels

Abstract BackgroundSince the implementation of the three‑child policy in China, the number of high-risk pregnant women has increased, causing serious challenges to health care during pregnancy. In this article, we aimed to investigate the impact of several risk factors for maternal and neonatal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) and recurrent GDM to formulate a management strategy to minimize the effect of risk factors for gestational diabetes. ResultsPre-pregnancy body mass index (BMI) and gestational weight gain affect maternal and child outcomes in the first and second onset of GDM. Pregnancy interval and fasting blood glucose in early pregnancy influence maternal and child outcomes of recurrent GDM. Maternal lipid levels during early pregnancy have a marked influence on neonatal outcomes in recurrent GDM.ConclusionsOn the basis of this result, weight management should be closely monitored before and during pregnancy. For planning of the second pregnancy with a previous history of GDM, a reasonable time between pregnancies is ideal. Moreover, in the next pregnancy, control of fasting blood glucose and lipid levels during the first trimester is necessary to improve both maternal and child outcomes.

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