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Sci Rep. 2018 Sep 6;8(1):13392. doi: 10.1038/s41598-018-31614-z.

Prediction of Gestational Diabetes Mellitus and Pre-diabetes 5 Years Postpartum using 75 g Oral Glucose Tolerance Test at 14-16 Weeks' Gestation.

Author information

1
Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. tove.lekva@rr-research.no.
2
Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
3
Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
4
Faculty of Medicine, University of Oslo, Oslo, Norway.
5
Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Aker, Oslo, Norway.
6
Mother Infant Research Institute, Tufts Medical Center, Boston, MA, USA.
7
Department of Obstetrics & Gynecology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
8
Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
9
K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway.
10
K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway.
11
Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
12
National Advisory Unit for Womens Health, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Abstract

Early detection and treatment of women at risk for gestational diabetes mellitus (GDM) could improve perinatal and long-term outcomes in GDM women and their offspring. We explored if a 75 g oral glucose tolerance test (OGTT) at 14-16 weeks of gestation could identify women who will (1) develop GDM or give birth to large-for-gestational-age (LGA) babies in 1031 pregnant women from the STORK study using different diagnostic criteria (WHO1999, IADPSG2010, WHO2013, NORWAY2017) and (2) develop pre-diabetes 5 years postpartum focusing on first trimester β-cell function in a separate study of 300 women from the STORK cohort. The sensitivity of the 14-16 week OGTT to identify women who would develop GDM or have LGA babies was low, and we could not identify alternative cut-offs to exclude women not at risk or identify women that could benefit from early intervention. First trimester β-cell function was a stronger determinant than third trimester β-cell function of predicting maternal pre-diabetes. In conclusion, in our normal low-risk population, the 75 g OGTT at 14-16 weeks is insufficient to identify candidates for early treatment of GDM or identify women not likely to develop GDM or have LGA babies. First trimester β-cell function may predict pre-diabetes 5 years postpartum.

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