Abstract
Although debated, most preeminent expert panels recommend routine screening for gestational diabetes mellitus (GDM). Among the many tests that have been used and evaluated for the screening of GDM, the fasting plasma glucose (FPG) remains very appealing. It is easy to administer, well tolerated, inexpensive, reproducible and patient friendly. However attractive, the FPG has given varied results in different populations and its use as a screening test for GDM remains uncertain. This review will objectively assess the available studies to find the real value of FPG as a screening test for GDM.
Similar content being viewed by others
References
Brody SC, Harris R, Lohr K (2003) Screening for gestational diabetes: a summary of the evidence for the U.S. Preventive Services Task Force. Obstet Gynecol 101:380–392
Agarwal MM, Dhatt GS, Punnose J, Koster G (2006) Gestational diabetes remains a riddle wrapped in a mystery inside an enigma. Acta Obstet Gynecol Scand 85:763
Greene MF (1997) Screening for gestational diabetes mellitus. N Engl J Med 337:1625–1626
Vogel N, Burnand B, Vial Y, Ruiz J, Paccaud F, Hohlfeld P (2000) Screening for gestational diabetes: variation in guidelines. Eur J Obstet Gynecol Reprod Biol 91:29–36
Gestational Diabetes Mellitus (2004) Position statement American Diabetes Association. Diab Care 27(Suppl 1):S88–S90
World Health Organization (1999) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1. Diagnosis and classification of diabetes mellitus. Report of a WHO Consultation, WHO, Geneva
American College of Obstetricians, Gynecologists (2001) Clinical management guidelines for obstetrician–gynecologists. Gestational diabetes. ACOG Practice Bulletin 30. Obstet Gynecol 98:525–538
Canadian Diabetes Association Clinical Practice Guidelines Expert Committee (2003) Canadian Diabetes Association Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 27(Suppl 2):S99–S105
The Australasian Diabetes in Pregnancy Society (1998) Gestational diabetes mellitus guidelines. Med J Aust 169:93–97
Report of the Pregnancy and Neonatal Care Group of the European Association for the Study of Diabetes (1996) Diabet Med 13:S43–S53
Agarwal MM, Dhatt GS, Punnose J, Koster G (2005) Gestational diabetes: dilemma caused by multiple international diagnostic criteria. Diabet Med 22:1731–1736
Greene MF, Solomon CG (2005) Gestational diabetes mellitus—time to treat. N Engl J Med 352:2544–2546
National Collaborating Centre for Women’s, Children’s Health (2003) Antenatal care: routine care for the healthy pregnant woman. RCOG Press, London
Scott DA, Loveman E, McIntyre L, Waugh N (2002) Screening for gestational diabetes: a systematic review and economic evaluation. Health Technol Assess 6:1–172
Agarwal MM, Dhatt GS, Punnose J, Koster G (2005) Gestational diabetes: a reappraisal of HBA1c as a screening test. Acta Obstet Gynecol Scand 84:1159–1163
Hanna FWF, Peters JR (2002) Screening for gestational diabetes; past, present and future. Diabet Med 19:351–358
Tuomilehto J (2002) Point: a glucose tolerance test is important for clinical practice. Diab Care 25:1880–1882
Davidson MB (2002) Counterpoint: the oral glucose tolerance test is superfluous. Diab Care 25:1883–1885
Agarwal MM, Punnose J, Dhatt GS (2004) Gestational diabetes: problems associated with the oral glucose tolerance test. Diab Res Clin Pract 63:73–74
Rey E (1999) Screening for gestational diabetes mellitus. Br Med J 319:798–799
BMA (2004) Diabetes mellitus: an update for healthcare professionals. http://www.bma.org.uk/ap.nsf/Content/Diabetes/$file/diabetes.pdf
Mortensen HB, Molsted-Pedersen L, Kuhl C, Backer P (1985) A screening procedure for diabetes in pregnancy. Diabete Metab 11:249–253
Sacks DA, Greenspoon JS, Fotheringham N (1992) Could the fasting plasma glucose assay be used to screen for gestational diabetes? J Reprod Med 37:907–909
Atilano LC, Lee-Parritz A, Lieberman E, Cohen AP, Barbieri R (1999) Alternative methods of diagnosing gestational diabetes mellitus. Am J Obstet Gynecol 181:1158–1161
Maegawa Y, Sugiyama T, Kusaka H, Mitao M, Toyoda N (2003) Screening tests for gestational diabetes in Japan in the 1st and 2nd trimester of pregnancy. Diab Res Clin Pract 62:47–53
The DECODE Study Group (Diabetes Epidemiology: Collaborative Analysis Of Diagnostic Criteria in Europe) (1999) Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. Lancet 354:617–621
DECODE Study (Diabetes Epidemiology: Collaborative Analysis Of Diagnostic Criteria in Europe) (1999) Consequences of the new diagnostic criteria for diabetes in older men and women. Diab Care 22:1667–1671
Perucchini D, Fischer U, Spinas GA, Huch R, Huch A, Lehmann R (1999) Using fasting plasma glucose concentrations to screen for gestational diabetes mellitus: prospective population based study. BMJ 319:812–815
Henderson AR (1993) Assessing test accuracy and its clinical consequences: a primer for receiver operating characteristic curve analysis. Ann Clin Biochem 30:521–539
Sacks DA, Chen W, Wolde-Tsadik G, Buchanan TA (2003) Fasting plasma glucose test at the first prenatal visit as a screen for gestational diabetes. Obstet Gynecol 101:1197–1203
de Aguiar LG, de Matos HJ, de Brito Gomes M (2001) Could fasting plasma glucose be used for screening high-risk outpatients for gestational diabetes mellitus? Diab Care 24:954–955
Agarwal MM, Hughes PF, Ezimokhai M (2000) Screening for gestational diabetes in a high risk population using fasting plasma glucose. Int J Gynecol Obstet 68:147–148
Agarwal MM, Hughes PF, Punnose J, Ezimokhai M (2000) Fasting plasma glucose as a screening test for gestational diabetes in a multi-ethnic, high-risk population. Diabet Med 17:720–726
Rey E, Hudon L, Michon N, Boucher P, Ethier J, Saint-Louis P (2004) Fasting plasma glucose versus glucose challenge test: screening for gestational diabetes and cost effectiveness. Clin Biochem 37:780–784
Senanayake H, Seneviratne S, Ariyaratne H, Wijeratne S (2006) Screening for gestational diabetes mellitus in southern Asian women. J Obstet Gynaecol Res 32:286–291
Reichelt AJ, Spichler ER, Branchtein L, Nucci LB, Franco LJ, Schmidt MI (1998) Fasting plasma glucose is a useful test for the detection of gestational diabetes. Brazilian Study of Gestational Diabetes (EBDG) Working Group. Diab Care 21:1246–1249
Tam WH, Rogers MS, Yip SK, Lau TK, Leung TY (2000) Which screening test is the best for gestational impaired glucose tolerance and gestational diabetes mellitus? Diab Care 23:1432
Agarwal MM, Dhatt GS, Punnose J, Koster G (2005) Gestational diabetes in a high-risk population: using the fasting plasma glucose to simplify the diagnostic algorithm. Eur J Obstet Gynecol Reprod Biol 120:39–44
Agarwal MM, Dhatt GS, Punnose J (in press) Gestational diabetes: utility of fasting plasma glucose as a screening test depends upon the diagnostic criteria. Diabet Med
Agarwal MM, Dhatt GS, Punnose J, Zayed R (in press) Gestational diabetes: fasting and post-prandial glucose as first prenatal visit screening tests in a high-risk population. J Reprod Med
Svare JA, Hansen BB, Molsted-Pedersen L (2001). Perinatal complications in women with gestational diabetes mellitus. Acta Obstet Gynecol Scand 80:899–904
Bartha JL, Martinez-Del-Fresno P, Comino-Delgado R (2000) Gestational diabetes mellitus diagnosed during early pregnancy. Am J Obstet Gynecol 182:346–350
Ouzilleau C, Roy MA, Leblanc L, Carpentier A, Maheux P (2003) An observational study comparing 2-hour 75-g oral glucose tolerance with fasting plasma glucose in pregnant women: both poorly predictive of birth weight. CMAJ 168:403–409
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Agarwal, M.M., Dhatt, G.S. Fasting plasma glucose as a screening test for gestational diabetes mellitus. Arch Gynecol Obstet 275, 81–87 (2007). https://doi.org/10.1007/s00404-006-0245-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-006-0245-9