Can fasting plasma glucose replace oral glucose-tolerance test for diagnosis of gestational diabetes mellitus?

Sepideh Babaniamansour; Ehsan Aliniagerdroudbari; Maryam Afrakhteh; Farhad Hosseinpanah; Farah Farzaneh; Mahtab Niroomand

doi:10.1007/s13340-020-00484-0

Can fasting plasma glucose replace oral glucose-tolerance test for diagnosis of gestational diabetes mellitus?

Diabetol Int. 2021 Jan 2;12(3):277-285. doi: 10.1007/s13340-020-00484-0. eCollection 2021 Jul.

Authors

Sepideh Babaniamansour¹, Ehsan Aliniagerdroudbari², Maryam Afrakhteh³, Farhad Hosseinpanah⁴, Farah Farzaneh⁵, Mahtab Niroomand⁶

Affiliations

¹ Department of Internal Medicine, School of Medicine, Islamic Azad University Tehran Faculty of Medicine, Tehran, Iran.
² Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ Department of Obstetrics and Gynecology, Gynecology Cancer Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶ Department of Internal Medicine, Division of Endocrinology, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, Velenjak, 7th Floor, Bldg. No. 2, Tehran, Iran.

Abstract

Background and aims: Gestational diabetes mellitus (GDM) has high prevalence worldwide. This study aimed to evaluate the fasting plasma glucose (FPG) cutoffs at first prenatal visit and at 24-28th of gestational weeks to avoid obtaining full oral glucose-tolerance test (OGTT) in the diagnosis of GDM.

Methods: This study was a cross-sectional study conducted in Tehran, Iran during October 2016 and November 2017. All pregnant women reporting for the first routine prenatal visit before 20th week of gestational age were included in this study. Participants without overt diabetes mellitus at first prenatal visit, underwent OGTT at 24-28th of gestational weeks.

Results: Totally 952 pregnant women with mean age of 26.4 ± 14.1 years took part in this study. The prevalence of GDM was 12.7% (mostly diagnosed based on the FPG alone). FPG cutoffs 75 and 80 mg/dL at first prenatal visit and at 24-28th of gestational weeks can rule out the GDM with high sensitivity and negative predictive value, respectively. FPG cutoffs 85 and 90 mg/dL at first prenatal visit and at 24-28th of gestational weeks had high capacity, excellent specificity and positive predictive value in diagnosing GDM, respectively.

Conclusions: Performing only the FPG and considering FPG cutoffs 75 and 80 mg/dL at first prenatal visit and at 24-28th of gestational weeks can be a useful tool predicting the incidence of GDM, respectively, and had similar diagnostic power.

Keywords: Diabetes, gestational; Glucose-tolerance test; Pregnant women; Prenatal care.