Early vs. Late Gestational Diabetes: Comparison between Two Groups Diagnosed by Abnormal Initial Fasting Plasma Glucose or Mid-Pregnancy Oral Glucose Tolerance Test

Tatiana Assuncao Zaccara; Cristiane Freitas Paganoti; Fernanda C Ferreira Mikami; Rossana P Vieira Francisco; Rafaela Alkmin Costa

doi:10.3390/ijerph192113719

Early vs. Late Gestational Diabetes: Comparison between Two Groups Diagnosed by Abnormal Initial Fasting Plasma Glucose or Mid-Pregnancy Oral Glucose Tolerance Test

Int J Environ Res Public Health. 2022 Oct 22;19(21):13719. doi: 10.3390/ijerph192113719.

Authors

Tatiana Assuncao Zaccara¹, Cristiane Freitas Paganoti², Fernanda C Ferreira Mikami², Rossana P Vieira Francisco¹, Rafaela Alkmin Costa¹

Affiliations

¹ Departamento de Obstetricia e Ginecologia da Faculdade de Medicina da, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil.
² Divisao de Clinica Obstetrica do Hospital das Clínicas da Faculdade de Medicina da, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil.

Abstract

Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. It may be diagnosed using a fasting plasma glucose (FPG) early in pregnancy (eGDM) or a 75-g oral glucose tolerance test (OGTT) (late GDM). This retrospective cohort of women with GDM presents data from 1891 patients (1004 in the eGDM and 887 in the late GDM group). Student's t-test, chi-squared or Fisher's exact test and the Bonferroni test for post hoc analysis were used to compare the groups. Women with eGDM had higher pre-pregnancy BMI, more frequent family history of DM, more frequent history of previous GDM, and were more likely to have chronic hypertension. They were more likely to deliver by cesarean section and to present an abnormal puerperal OGTT. Even though they received earlier treatment and required insulin more frequently, there was no difference in neonatal outcomes. Diagnosing and treating GDM is necessary to reduce complications and adverse outcomes, but it is still a challenge. We believe that women with eGDM should be treated and closely monitored, even though this may increase healthcare-related costs.

Keywords: IADPSG; early-onset GDM; gestational diabetes; oral glucose tolerance test.

MeSH terms

Blood Glucose
Cesarean Section
Diabetes, Gestational* / diagnosis
Diabetes, Gestational* / epidemiology
Fasting
Female
Glucose Intolerance* / diagnosis
Glucose Intolerance* / epidemiology
Glucose Tolerance Test
Humans
Infant, Newborn
Pregnancy
Pregnancy Outcome
Retrospective Studies

Substances

Blood Glucose

Grants and funding

This research received no external funding.