Fasting Glycemia May Be Beneficial for Gestational Diabetes Screening

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Fasting glycemia may be an acceptable alternative to 75-g glucose tolerance test for gestational diabetes screening.
Fasting glycemia may be an acceptable alternative to 75-g glucose tolerance test for gestational diabetes screening.

(HealthDay News) — Screening for gestational diabetes with fasting glycemia seems to be an acceptable alternative to universal screening with the complete 75-g glucose tolerance test, according to a study published in BJOG: An International Journal of Obstetrics & Gynaecology.

J. Ryser Rüetschi, from the University Hospitals of Geneva, and colleagues collected 2298 complete 75-g glucose tolerance tests from pregnant women at 24 to 28 weeks of gestation. They simulated stopping the test if fasting glycemia was less than 4.4 mmol/L or 5.1 mmol/L or greater, thereby avoiding glucose loading and further glycemia.

The researchers found that within the population, the prevalence of gestational diabetes was 10.9%. Among 251 women with gestational diabetes, fasting glycemia was at least 5.1 mmol/L, between 4.4 mmol/L and less than 5.1 mmol/L, and less than 4.4 mmol/L in 47.4%, 31.1%, and 21.5%, respectively. The sensitivity was 78.5% with performance of the complete test only in women with fasting glycemia between 4.4 mmol/L and less than 5.1 mmol/L; this would avert glucose loading in 63.8% of women.

"Screening with fasting glycemia is an attractive alternative to universal screening with the complete 75-g glucose tolerance test," the researchers wrote. "This strategy is, however, slightly less sensitive than previously reported in higher-risk populations."

Reference

  1. Rüetschi JR, Jornayvaz FR, Rivest R, Huhn EA, Irion O, Boulvain M. Fasting glycaemia to simplify screening for gestational diabetes. BJOG. 2016. doi:10.1111/1471-0528.13857.
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