Relevance of Serum Fructosamine and Random Blood Glucose for the Screening of Gestational Diabetes Mellitus

2005 ◽  
Vol 1 (1) ◽  
pp. 41-46
Author(s):  
Haseeb A. Khan . ◽  
Abdurrahman S. Alhom . ◽  
Samia H. Sobki . ◽  
Shaukat A. Khan .
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Random Blood Glucose ◽  
Serum Fructosamine

scholarly journals Accuracy of glycosuria, random blood glucose and risk factors as selective screening tools for gestational diabetes mellitus in comparison with universal diagnosing

2018 ◽  
Vol 6 (1) ◽  
pp. e000493 ◽  
Author(s):  
Faith Agbozo ◽  
Abdulai Abubakari ◽  
Clement Narh ◽  
Albrecht Jahn
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Test Performance ◽  
Gold Standard ◽  
Universal Screening ◽  
Selective Screening ◽  
Random Blood Glucose

ObjectiveDespite the short-term and long-term health implications of gestational diabetes mellitus (GDM), opinions are divided on selective vis-à-vis universal screening. We validated the accuracy of screening tests for GDM.Research design and methodsPregnant women (n=491) were recruited to this prospective, blind comparison with a gold standard study. We did selective screening between 13 and 20 weeks using reagent-strip glycosuria, random capillary blood glucose (RBG) and the presence of ≥1 risk factor(s). Between 20 and 34 weeks, we did universal screening following the ‘one-step’ approach using glycated hemoglobin (HbA1c), fasting venous plasma glucose (FPG), and the 1-hour and the ‘gold standard’ 2-hour oral glucose tolerance test (OGTT). Tests accuracy was estimated following the WHO and the National Institute for Health and Care Excellence (NICE) diagnostic criteria. Overall test performance was determined from the area under the receiver operating characteristic curve (AUC).ResultsGDM prevalence per 2-hour OGTT was 9.0% for the WHO criteria and 14.3% for the NICE criteria. Selective screening using glycosuria, RBG and risk factors missed 97.4%, 87.2% and 45.7% of cases, respectively. FPG threshold ≥5.1 mmol/L had the highest clinically relevant sensitivity (68%) and specificity (81%), but FPG threshold ≥5.6 mmol/L had higher positive predictive value. Although sensitivity of 1-hour OGTT was 39.5%, it had the highest accuracy and diagnostic OR. Regarding test performance, 1-hour OGTT and FPG were very good (AUC>0.8), RBG was poor (AUC≈0.60), whereas HbA1c was invaluable (AUC<0.5).ConclusionsSelective screening using glycosuria and random blood glucose is unnecessary due to its low sensitivity. Fasting glucose ≥5.1 mmol/L could be applicable for screening at the population level. Where 2-hour OGTT is not available, FPG ≥5.6 mmol/L, complemented by the presence of risk factors, could be useful in making therapeutic decision.

scholarly journals Safe threshold of capillary blood glucose for predicting early future neonatal hypoglycaemia in babies born to mothers with gestational diabetes mellitus, an observational, retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Esther H. G. Park ◽  
Frances O’Brien ◽  
Fiona Seabrook ◽  
Jane Elizabeth Hirst
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Capillary Blood ◽  
Capillary Blood Glucose ◽  
Neonatal Hypoglycaemia

Abstract Background There is increasing pressure to get women and babies home rapidly after birth. Babies born to mothers with gestational diabetes mellitus (GDM) currently get 24-h inpatient monitoring. We investigated whether a low-risk group of babies born to mothers with GDM could be defined for shorter inpatient hypoglycaemia monitoring. Methods Observational, retrospective cohort study conducted in a tertiary maternity hospital in 2018. Singleton, term babies born to women with GDM and no other risk factors for hypoglycaemia, were included. Capillary blood glucose (BG) testing and clinical observations for signs of hypoglycaemia during the first 24-h after birth. BG was checked in all babies before the second feed. Subsequent testing occurred if the first result was < 2.0 mmol/L, or clinical suspicion developed for hypoglycaemia. Neonatal hypoglycaemia, defined as either capillary or venous glucose ≤ 2.0 mmol/L and/or clinical signs of neonatal hypoglycaemia requiring oral or intravenous dextrose (lethargy, abnormal feeding behaviour or seizures). Results Fifteen of 106 babies developed hypoglycaemia within the first 24-h. Maternal and neonatal characteristics were not predictive. All babies with hypoglycaemia had an initial capillary BG ≤ 2.6 mmol/L (Area under the ROC curve (AUC) 0.96, 95% Confidence Interval (CI) 0.91–1.0). This result was validated on a further 65 babies, of whom 10 developed hypoglycaemia, in the first 24-h of life. Conclusion Using the 2.6 mmol/L threshold, extended monitoring as an inpatient could have been avoided for 60% of babies in this study. Whilst prospective validation is needed, this approach could help tailor postnatal care plans for babies born to mothers with GDM.

Searching for Utopia, the Challenge of Standardized Medical Nutrition Therapy Prescription in Gestational Diabetes Mellitus Management: A Critical Review

2021 ◽  
Author(s):  
Nina Meloncelli ◽  
Shelley A. Wilkinson ◽  
Susan de Jersey
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Lifestyle Modification ◽  
Nutrition Therapy ◽  
Medical Nutrition Therapy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Medical Nutrition

AbstractGestational diabetes mellitus (GDM) is a common pregnancy disorder and the incidence is increasing worldwide. GDM is associated with adverse maternal outcomes which may be reduced with proper management. Lifestyle modification in the form of medical nutrition therapy and physical activity, as well as self-monitoring of blood glucose levels, is the cornerstone of GDM management. Inevitably, the search for the “ultimate” diet prescription has been ongoing. Identifying the amount and type of carbohydrate to maintain blood glucose levels below targets while balancing the nutritional requirements of pregnancy and achieving gestational weight gain within recommendations is challenging. Recent developments in the area of the gut microbiota and its impact on glycemic response add another layer of complexity to the success of medical nutrition therapy. This review critically explores the challenges to dietary prescription for GDM and why utopia may never be found.

scholarly journals Oleuropein alleviates gestational diabetes mellitus by activating AMPK signaling

2020 ◽  
Author(s):  
Zhiwei Zhang ◽  
Hui Zhao ◽  
Aixia Wang
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Body Weight ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Signaling Pathway ◽  
Hepatic Glycogen ◽  
Ampk Signaling ◽  
Tnf Α

Background: Gestational diabetes mellitus (GDM) has a high incidence rate among pregnant women. The objective of the study was to assess the effect of plant-derived oleuropein in attenuating inflammatory and oxidative stress of GDM. Methods: Oleuropein was administered to GDM mice at the doses of 5 or 10 mg/kg/day. Body weight, blood glucose, insulin and hepatic glycogen levels were recorded. To evaluate the effect of oleuropein in reducing oxidative stress, enzyme-linked immunosorbent assay (ELISA) was used to measure the hepatic oxidative stress markers. The inflammation levels of GDM mice were evaluated by measuring serum levels of IL-6 and TNF-α by ELISA, and mRNA levels of IL-1β, TNF-α and IL-6 by real-time PCR (RT-PCR). The AMP-activated protein kinase (AMPK) signaling pathway was assessed by Western blot. Gestational outcome was analyzed through comparing litter size and birth weight. Results: Oleuropein attenuated the elevated body weight of GDM mice, and efficiently reduced blood glucose, insulin and hepatic glycogen levels. Oxidative stress and inflammation were alleviated by oleuropein treatment. The AMPK signaling was activated by oleuropein in GDM mice. Gestational outcome was markedly improved by oleuropein treatment. Conclusions: Our study suggests that oleuropein is effective in alleviating symptoms of GDM and improving gestational outcome in the mouse model. This effect is achieved by attenuating oxidative stress and inflammation, which is mediated by the activation of the AMPK signaling pathway.

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.

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