Difference between 2 h and 3 h 75 g glucose tolerance test in the diagnosis of gestational diabetes mellitus (GDM): Results from a national survey on prevalence of GDM
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The possibility of the 2 h oral glucose tolerance test (OGTT) as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes. Data were retrieved from 4179 pregnant women who had OGTT performed after an abnormal 50 g glucose challenge test (GCT). All of the 4 glucose levels during their OGTT were collected and analyzed. According to American Diabetes Association (ADA) gestational diabetes mellitus (GDM) diagnostic criteria, among the 4179 pregnant women who required OGTT, 3429 (82.1%) were normal and 750 (17.9%) were diagnosed as GDM. If the 3rd h glucose levels were omitted from OGTT, 79 cases of GDM (10.5%) would be overlooked. No trend was shown where women with more risk factors were more likely to be overlooked if the 3rd h test was omitted (χ2 for trend = 0.038, P > 0.05). No significant differences were found in the rate of cesarean section (CS), preterm births or macrosomia between the 79 cases and those with normal OGTT results and in the gestational weeks when OGTT was performed. It shows that in order to diagnose one woman with GDM, another 52 pregnant women would have an innocent 3rd h glucose test. Omission of the 3rd h glucose test in OGTT might be reasonable due to its convenience, better compliance and a small number of possibly miss-diagnosed cases, and their pregnancy outcomes have no significant difference from those of normal pregnant women.
Keywordsdiabetes gestational oral glucose tolerance test
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- 2.Gao X L, Yang H X. Current situation of the studies on pregnancy associated with diabetes in China. Zhongguo Quan Ke Yi Xue, 2008, 11(4A): 547–550 (in Chinese)Google Scholar
- 3.Yang H, Wei Y, Gao X, Xu X, Fan L, He J, Hu Y, Liu X, Chen X, Yang Z, Zhang C; China National GDM Survey Working Group. Risk factors for gestational diabetes mellitus in Chinese women: a prospective study of 16,286 pregnant women in China. Diabet Med, 2009, 26(11): 1099–1104CrossRefPubMedGoogle Scholar
- 6.Cunningham F G, Gant N F, Leveno K J, Gilstrap L C III, Hauth J C, Wenstrom K D. Williams Obstetrics. 23rd ed. New York: McGraw-Hill, 2005, 127–128Google Scholar
- 7.Xie Y, Xu X M, Li S D. Feasibility of diagnosing gestational diabetes mellitus by oral glucose tolerance test without the third-hour plasma glucose level. Zhonghua Wei Chan Yi Xue Za Zhi, 2005, 8(2): 89–91 (in Chinese)Google Scholar
- 10.Hod M, Jovanovic L, Di Renzo G C. Textbook of Diabetes and Pregnancy. London: Martin Dunitz, 2003, 32–64Google Scholar
- 11.Yang H X, Gao X L, Dong Y, Shi C Y. Analysis of oral glucose tolerance test in pregnant women with abnormal glucose metabolism. Chin Med J (Engl), 2005, 118(12): 995–999Google Scholar
- 12.Qin SW, Cheng N H, Liu J T, Shan Y, Bian XM, Xiang H D. 100 g oral glucose tolerance test in patients with gestational diabetes mellitus. Shengzhi Yi Xue Za Zhi, 2007, 16(1): 1–3 (in Chinese)Google Scholar