Criteria for screening and diagnosis of gestational diabetes mellitus in the first trimester of pregnancy

Fetal Diagn Ther. 2011;30(2):108-15. doi: 10.1159/000324684. Epub 2011 Apr 1.

Abstract

Objective: To propose new cutoffs in plasma glucose levels in screening and diagnosis of gestational diabetes mellitus (GDM) in the first trimester of pregnancy.

Methods: A 50-gram oral glucose challenge test (GCT) was performed in 1,716 singleton pregnancies at 6-14 weeks' gestation. In those with a positive GCT, a 100-gram glucose tolerance test (GTT) was carried out. The GCT and as necessary the GTT were repeated at 20-30 weeks. The relation of the results of the GCT and GTT at 6-14 weeks to that at 20-30 weeks was examined.

Results: The diagnosis of GDM was made in 85 cases. In the GCT, there was a significant association between 1-hour plasma glucose levels at 6-14 weeks and at 20-30 weeks (r = 0.558, p < 0.0001), and in all cases of GDM, the level was 130 mg/dl or more at 6-14 weeks and 140 mg/dl or more at 20-30 weeks. In the GTT, the plasma glucose 1, 2 and 3 h after the 100-gram glucose load at 6-14 weeks was, respectively, 18, 29 and 35% lower than at 20-30 weeks.

Conclusion: Effective diagnosis of GDM in the first trimester can be achieved by lowering the GCT and GTT plasma glucose cutoffs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose
  • Clinical Protocols
  • Diabetes, Gestational / diagnosis*
  • Female
  • Glucose Tolerance Test*
  • Humans
  • Patient Selection
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Trimester, First*
  • Prenatal Diagnosis / methods*

Substances

  • Blood Glucose