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The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy

Year 2023, Volume: 40 Issue: 3, 550 - 555, 30.09.2023

Kübra Baki Erin Turhan Aran Asım Örem

Abstract

We aimed to evaluate the effectiveness of the first trimester's 50 g glucose loading as a screening test for gestational diabetes mellitus and to find a cut-off value for 50 g OGCT in the first trimester. This study was conducted on pregnant women at low risk for diabetes mellitus. A 50-g glucose load was done in the first trimester, and then pregnant women were followed up. A 100-gram diagnostic test for gestational diabetes mellitus was administered to all participants at 24–28 weeks of gestation. The sensitivity, specificity, and false-positive rate of the 50 g glucose challenge test were determined. A total of 454 pregnant women were assessed in this study. 34 women (7.5%) were diagnosed with gestational diabetes. 420 women have constituted the non-diabetic group. In patients with gestational diabetes, age, weight, polyhydramnios, and macrosomia rates were significantly higher than in the non-diabetic group. The discriminative power of the 50 g glucose test in the first trimester was found to be significant (p = 0.001) in gestational diabetic patients. The area under the ROC curve was 0.927. The best cut-off value was 143 mg/dl. In this value, the sensitivity and false-positive rate were 85% and 11%, respectively. A 50-g glucose challenge test done in the first trimester may contribute to the reduction of maternal and perinatal risks and prevent long-term consequences such as obesity, type 2 diabetes mellitus, and lipid profile disorders with early glycemic control and lifestyle changes.

Keywords

Diabetic complications First trimester pregnancy Gestational diabetes mellitus 50 g glucose loading test

Project Number

2010.114.002

References

  • 1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2005;28:37-42.
  • 2. Kühl C. Glucose metabolism during and after pregnancy in normal and gestational diabetic women. 1. Influence of normal pregnancy on serum glucose and insulin concentration during basal fasting conditions and after a challenge with glucose. Acta Endocrinol. 1975;79(4):709-19.
  • 3. Farrar D, Duley L, Dowswell T, Lawlor DA. Different strategies for diagnosing gestational diabetes to improve maternal and infant health. Cochrane Database Syst Rev. 2017;23;8(8):CD007122.
  • 4. American College of Obstetricians and Gynecologists Washington DC: ACOG;2001: ACOG Practice Bulletin Number 30
  • 5. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2006;29:43-8.
  • 6. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS; Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005.16;352(24):2477-86.
  • 7. Langer, O, Yogev, Y, Most, O, Xenakis, EM: Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol.2005;192:989.
  • 8. Nahum GG, Huffaker BJ. Correlation between first- and early third-trimester glucose screening test results. Obstet Gynecol. 1990;76(4):709-13.
  • 9. Yeral MI, Ozgu-Erdinc AS, Uygur D, Seckin KD, Karsli MF, Danisman AN. Prediction of gestational diabetes mellitus in the first trimester, comparison of fasting plasma glucose, two-step and one-step methods: a prospective randomized controlled trial. Endocrine. 2014;46(3):512-8.
  • 10. Bhattacharya SM. Glucose screening test results in first and early third trimester of pregnancy: is there any correlation? J Obstet Gynaecol Res. 2002;28(6):304-7.
  • 11. Lorie M Harper, Victoria Jauk, Sherri Longo, Joseph R Biggio, Jeff M Szychowski, Alan T Tita . Early gestational diabetes screening in obese women: a randomized controlled trial. Am J Obstet Gynecol. 2020;222(5):49
  • 12. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982;144:768–73.
  • 13. Kim KS, Hong S, Han K, Park CY. The clinical characteristics of gestational diabetes mellitus in Korea: a National Health Information Database Study. Endocrinol Metab. 2021;36: 628-36.
  • 14. C Wren, G Birrell, G Hawthorne: Cardiovascular malformations in infants of diabetic mothers. Heart 2003;89:1217–1220
  • 15. Dorte M. Jensen, PHD1, Peter Damm et al: Outcomes in Type 1 Diabetic Pregnancies: Diabetes Care 2004;27:2819–2823
  • 16. Roeder HA, Moore TR, Wolfson MT, Gamst AC, Ramos GA. Treating hyperglycemia in early pregnancy: a randomized controlled trial. Am J Obstet Gynecol MFM 2019;1:33–41.
  • 17. Yalçın HR, Zorlu CG Treshold value of glucose screening tests in pregnancy; could it be standardized for every population? Am J Perinat 1996;13(5):317–20.
  • 18. Pillay J, Donovan L, Guitard S, Zakher B, Gates M, Gates A, Vandermeer B, Bougatsos C, Chou R, Hartling L. Screening for Gestational Diabetes: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;10;326(6):539-562.
  • 19. Jokelainen M, Stach-Lempinen B, Rönö K, Nenonen A, Kautiainen H, Teramo K, Klemetti MM. Oral glucose tolerance test results in early pregnancy: A Finnish population-based cohort study. Diabetes Res Clin Pract. 2020;162:108077.
  • 20. Garner PR, D’Alton ME et al: Preeclampsia in diabetic pregnancies. Am J Obstet Gynecol.1990;163:505.
  • 21. Dashe JS, Nathan L, Leveno KJ: Correlation between amniotic fluid glucose correlation and amniotic fluid volume in pregnancy complicated by diabetes. Am J Obstet Gynecol.2000;182:901.
  • 22. Simmons D, Thompson CF, Conroy C: İncidence and risk factors for neonatal hypoglycaemia among women with gestational diabetes mellitus in South Auckland. Diabet Med. 2000;17:830.
  • 23. Rosenn B, Miodovnik M, Tsang R. Common clinical manifestations of maternal diabetes in newborn infants: implications for the practicing pediatrician. Pediatr Ann.1996;25:215.
  • 24. Sobia Alyas, Nabila Roohi, Samina Ashraf, Sadaf Ilyas, Azhar Ilyas. Early pregnancy biochemical markers of placentation for screening of gestational diabetes mellitus (GDM). Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(4): 2353-56.
  • 25. David K Ryan, Laura Haddow, Aksha Ramaesh, Rod Kelly, Emma C Johns, Fiona C Denison, Anna R Dover Rebecca M Reynolds. Early screening and treatment of gestational diabetes in high-risk women improves maternal and neonatal outcomes: A retrospective clinical audit. Diabetes Res Clin Pract. 2018;144:294-301.
  • 26. Feghali MN, Abebe KZ, Comer DM, Caritis S, Catov JM, Scifres CM. Pregnancy outcomes in women with an early diagnosis of gestational diabetes mellitus. Diabetes Res Clin Pract 2018;138:177–86.

Year 2023, Volume: 40 Issue: 3, 550 - 555, 30.09.2023

Kübra Baki Erin Turhan Aran Asım Örem

Abstract

Supporting Institution

Karadeniz Technical University

Project Number

2010.114.002

Thanks

Karadeniz Teknik Üniversitesi Bilimsel Araştırma Destek Fonuna teşekkür ederiz.

References

  • 1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2005;28:37-42.
  • 2. Kühl C. Glucose metabolism during and after pregnancy in normal and gestational diabetic women. 1. Influence of normal pregnancy on serum glucose and insulin concentration during basal fasting conditions and after a challenge with glucose. Acta Endocrinol. 1975;79(4):709-19.
  • 3. Farrar D, Duley L, Dowswell T, Lawlor DA. Different strategies for diagnosing gestational diabetes to improve maternal and infant health. Cochrane Database Syst Rev. 2017;23;8(8):CD007122.
  • 4. American College of Obstetricians and Gynecologists Washington DC: ACOG;2001: ACOG Practice Bulletin Number 30
  • 5. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2006;29:43-8.
  • 6. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS; Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005.16;352(24):2477-86.
  • 7. Langer, O, Yogev, Y, Most, O, Xenakis, EM: Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol.2005;192:989.
  • 8. Nahum GG, Huffaker BJ. Correlation between first- and early third-trimester glucose screening test results. Obstet Gynecol. 1990;76(4):709-13.
  • 9. Yeral MI, Ozgu-Erdinc AS, Uygur D, Seckin KD, Karsli MF, Danisman AN. Prediction of gestational diabetes mellitus in the first trimester, comparison of fasting plasma glucose, two-step and one-step methods: a prospective randomized controlled trial. Endocrine. 2014;46(3):512-8.
  • 10. Bhattacharya SM. Glucose screening test results in first and early third trimester of pregnancy: is there any correlation? J Obstet Gynaecol Res. 2002;28(6):304-7.
  • 11. Lorie M Harper, Victoria Jauk, Sherri Longo, Joseph R Biggio, Jeff M Szychowski, Alan T Tita . Early gestational diabetes screening in obese women: a randomized controlled trial. Am J Obstet Gynecol. 2020;222(5):49
  • 12. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982;144:768–73.
  • 13. Kim KS, Hong S, Han K, Park CY. The clinical characteristics of gestational diabetes mellitus in Korea: a National Health Information Database Study. Endocrinol Metab. 2021;36: 628-36.
  • 14. C Wren, G Birrell, G Hawthorne: Cardiovascular malformations in infants of diabetic mothers. Heart 2003;89:1217–1220
  • 15. Dorte M. Jensen, PHD1, Peter Damm et al: Outcomes in Type 1 Diabetic Pregnancies: Diabetes Care 2004;27:2819–2823
  • 16. Roeder HA, Moore TR, Wolfson MT, Gamst AC, Ramos GA. Treating hyperglycemia in early pregnancy: a randomized controlled trial. Am J Obstet Gynecol MFM 2019;1:33–41.
  • 17. Yalçın HR, Zorlu CG Treshold value of glucose screening tests in pregnancy; could it be standardized for every population? Am J Perinat 1996;13(5):317–20.
  • 18. Pillay J, Donovan L, Guitard S, Zakher B, Gates M, Gates A, Vandermeer B, Bougatsos C, Chou R, Hartling L. Screening for Gestational Diabetes: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;10;326(6):539-562.
  • 19. Jokelainen M, Stach-Lempinen B, Rönö K, Nenonen A, Kautiainen H, Teramo K, Klemetti MM. Oral glucose tolerance test results in early pregnancy: A Finnish population-based cohort study. Diabetes Res Clin Pract. 2020;162:108077.
  • 20. Garner PR, D’Alton ME et al: Preeclampsia in diabetic pregnancies. Am J Obstet Gynecol.1990;163:505.
  • 21. Dashe JS, Nathan L, Leveno KJ: Correlation between amniotic fluid glucose correlation and amniotic fluid volume in pregnancy complicated by diabetes. Am J Obstet Gynecol.2000;182:901.
  • 22. Simmons D, Thompson CF, Conroy C: İncidence and risk factors for neonatal hypoglycaemia among women with gestational diabetes mellitus in South Auckland. Diabet Med. 2000;17:830.
  • 23. Rosenn B, Miodovnik M, Tsang R. Common clinical manifestations of maternal diabetes in newborn infants: implications for the practicing pediatrician. Pediatr Ann.1996;25:215.
  • 24. Sobia Alyas, Nabila Roohi, Samina Ashraf, Sadaf Ilyas, Azhar Ilyas. Early pregnancy biochemical markers of placentation for screening of gestational diabetes mellitus (GDM). Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(4): 2353-56.
  • 25. David K Ryan, Laura Haddow, Aksha Ramaesh, Rod Kelly, Emma C Johns, Fiona C Denison, Anna R Dover Rebecca M Reynolds. Early screening and treatment of gestational diabetes in high-risk women improves maternal and neonatal outcomes: A retrospective clinical audit. Diabetes Res Clin Pract. 2018;144:294-301.
  • 26. Feghali MN, Abebe KZ, Comer DM, Caritis S, Catov JM, Scifres CM. Pregnancy outcomes in women with an early diagnosis of gestational diabetes mellitus. Diabetes Res Clin Pract 2018;138:177–86.
There are 26 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Kübra Baki Erin 0000-0002-6626-1735

Turhan Aran 0000-0001-9488-9776

Asım Örem 0000-0001-8450-5783

Project Number 2010.114.002
Early Pub Date October 6, 2023
Publication Date September 30, 2023
Submission Date April 29, 2023
Acceptance Date August 23, 2023
Published in Issue Year 2023 Volume: 40 Issue: 3

Cite

APA Baki Erin, K., Aran, T., & Örem, A. (2023). The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy. Journal of Experimental and Clinical Medicine, 40(3), 550-555.
AMA Baki Erin K, Aran T, Örem A. The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy. J. Exp. Clin. Med. September 2023;40(3):550-555.
Chicago Baki Erin, Kübra, Turhan Aran, and Asım Örem. “The effıciency of the First Trimester 50 Grams Glucose Tolerance Test for Detection of the Gestational Diabetes and the Outcome of the Pregnancy”. Journal of Experimental and Clinical Medicine 40, no. 3 (September 2023): 550-55.
EndNote Baki Erin K, Aran T, Örem A (September 1, 2023) The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy. Journal of Experimental and Clinical Medicine 40 3 550–555.
IEEE K. Baki Erin, T. Aran, and A. Örem, “The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy”, J. Exp. Clin. Med., vol. 40, no. 3, pp. 550–555, 2023.
ISNAD Baki Erin, Kübra et al. “The effıciency of the First Trimester 50 Grams Glucose Tolerance Test for Detection of the Gestational Diabetes and the Outcome of the Pregnancy”. Journal of Experimental and Clinical Medicine 40/3 (September 2023), 550-555.
JAMA Baki Erin K, Aran T, Örem A. The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy. J. Exp. Clin. Med. 2023;40:550–555.
MLA Baki Erin, Kübra et al. “The effıciency of the First Trimester 50 Grams Glucose Tolerance Test for Detection of the Gestational Diabetes and the Outcome of the Pregnancy”. Journal of Experimental and Clinical Medicine, vol. 40, no. 3, 2023, pp. 550-5.
Vancouver Baki Erin K, Aran T, Örem A. The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy. J. Exp. Clin. Med. 2023;40(3):550-5.
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