1-G/KG glucose challenge test for screening of gestational diabetes mellitus

Aim

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The screening of GDM by using a 50 g glucose load is accepted worldwide however unrelated to body weight. Although in most of the studies overweight women and the women with high body mass indexes are excluded, the included women still have different weights and body mass indexes. In this prospective study, we aimed to analyze the effect of the women’s weight on glucose load for screening GDM by using 1g/kg glucose challenge test.

Yöntem

Pregnant women (n=163) without known diabetes or GDM, between the 24th-28th weeks of pregnancy were screened for GDM by 1 g glucose load per kg body weight in group A (n=103) and by 50 g glucose in group B. Serum glucose levels were measured before and one hour after the glucose load. Statistical analyses were performed by t-, Mann Whitney and Pearson’s tests. A p value of <0.05 was considered significant.

Bulgular

The demographic data of the participants and results of the comparison of the two glucose load methods are summarized in Table 1. In comparison to the 50 g load, the 1g/kg glucose load did not cause significant different values of plasma glucose levels 1 hour after the load (p>0.05). However, in accordance to the need for the 100 g OGTT, the odds ratio of 1.75 (0.8252 - 3.702; in 95% confidence interval) showed that the 50 g glucose load testing leads to more 100 g OGTTs. Although the maternal age correlated strongly with the maternal weight and initial glucose level, the maternal weight did not correlate with the initial glucose level. In group A, the maternal age correlated strongly with the maternal weight and the 1 hour glucose level, however did not correlate with the initial glucose levels. In addition, 1-hour glucose level correlated with the maternal age and the initial glucose level, but not with the maternal weight. In group B, the maternal age correlated strongly with the maternal weight and the 1-hour glucose level, however did not correlate with the initial glucose levels. In addition, 1-hour glucose level correlated with the maternal age and the initial glucose level, but not with the maternal weight. The rate of the need for a 100 g with the body weight (p>0.05). Although statistically not significant, the maternal weight correlations were higher in group A.

Sonuç

The 1g/kg glucose and the 50 g load tests have similar mean glucose levels at first hour of the glucose load; however, the 50 g load leads more women to the 100 g OGTT. The maternal age is better correlated with the glucose intolerance in comparison to the maternal weight. Further studies are needed to find out the test that has more diagnostic power and lower cost. 

Anahtar Kelimeler

Blood glucose, oral glucose tolerance, gestational diabetes, screening

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