Abstract:
A screening test for gestational diabetes should be capable of identifying for definitive (glucose tolerance) testing a large proportion of women who have the disease (sensitivity), while not identifying women for definitive testing who do not have the disease (specificity). Methods of screening include selecting patients with historical risk factors, hemoglobin A1c, fasting glucose concentrations, and the 50 g 1-hour glucose-screening test. Glucose concentrations with the latter vary with time of day and time after the last meal, and are poorly reproducible. Interposing a screening test prior to glucose tolerance testing trades ease of administration and reduced costs for the possibility of not identifying some women who have gestational diabetes.Keywords:
Screening test
Glucose tolerance test
Glucose tolerance test
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Glucose tolerance test
Screening test
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Objective To study the incidence of gestational diabetes and the relationship between gestational diabetes risk factors and abnormal glucose tolerance test.Methods Blood glucose levels of 24 weeks-28 weeks pregnant women were determined after 50 g oral glucose,glucose tolerance test(OGTT) was performed on subjects whose blood sugar level was higher than 7.8 mmol/L to get diagnosis.Results The incidence of gestational diabetes mellitus(GDM) was 1.26%.The incidence of Gestational impaired glucose tolerance(GTGT) was 2.95%,the incidences of subjects with gestational diabetes risk factors such as the history of abnormal pregnancy,DM family history,pre-pregnancy obesity or excessive weight gain during pregnancy were significantly different from those with no risk factors of abnormal glucose tolerance test(P0.01).Conclusion The misdiagnosis of gestational diabetes can reduced by blood sugar screening in all pregnant women,impaired glucose tolerance during pregnancy should be actively treated,pregnant women with the risk factors should be monitored specifically.
Glucose tolerance test
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Glucose test
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Objective To compare the results of glucose challenge test and oral glucose tolerance test.in diagnosis of gestational diabetes mellitus. Methods The informed content glucose challenge test and oral glucose tolerance test were carried out in voluntary pregnant women after positive screening and the results were analyzed. Results Glucose challenge test was conducted on 681 pregnant women and 78 of them were positive for gestational diabetes mellitus with a positive rate of 11.45%; then oral glucose tolerance test was performed in the 78 positives and 65 of them were positive for gestational diabetes mellitus with the positive rate of 9.54% ( 83.33%),without showing statistically significant differences between the two tests(χ2=1.32,P=0.25,P0.05). Conclusions The detection rate of glucose challenge test in diagnosis of gestational diabetes mellitus is high and it is simple and practicable for clinical purpose.
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Summary. Of 218 pregnant women with abnormal glucose tolerance by the criteria of the World Health Organization (1985) 81·2% had impaired glucose tolerance and 18·8% gestational diabetes. Gestational diabetic women were of higher parity, more obese, required insulin therapy more often, had more babies weighing >4 kg and had higher fasting plasma glucose than women with impaired glucose tolerance. Women with gestational impaired glucose tolerance were older, of higher parity, more obese and had heavier babies than pregnant women with a normal screening plasma glucose. Compared with women with impaired glucose tolerance, gestational diabetic women were more likely to have abnormality, and more severe impairment of their glucose tolerance test in the puerperium.
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In a retrospective review of 471 patients screened for gestational diabetes mellitus (GDM) in a community laboratory, we compared 50 g polycose screening test results with those of the 75 g oral glucose tolerance test (GTT). The rate of GDM diagnosis was compared using criteria promulgated by the New Zealand Society for Study of Diabetes (NZSSD), Australian Diabetes in Pregnancy Society (ADIPS) and World Health Organisation (WHO). In those with borderline screening results (7.8-8 mmol/L) the rate of GDM diagnosis using NZSSD criteria was low (2.8%) compared with higher screening test results (> or = 8.1 mmol/L), where the rate was 7.4%. Corresponding rates were 7.5% and 13.5% using ADIPS criteria and 5.6% and 12.4% using WHO criteria. The predictive value of a positive 50 g screening test is therefore low, especially for the higher New Zealand criteria. In women with borderline screening results no subject had a two-hour plasma glucose of 9.0 mmol/L or more on oral GTT. This suggests that the current screening cut-off of 7.8 mmol/L might be raised to 8.1 mmol/L, resulting in a 25% reduction in the number of glucose tolerance tests. Those with significant risk factors such as macrosomia, however, still warrant greater clinical suspicion and closer follow-up.
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Oral glucose tolerance testing was performed according to WHO criteria among pregnant women with historical risk factors for gestational diabetes (a previous baby weighing 4000 g or more, a previous unexplained intrauterine death) in Baranya county. Oral glucose tolerance test was carried out for the first time between gestational ages of 16-20 weeks, and it was repeated monthly in cases of normal curve. Patients with impaired glucose tolerance or diabetes were cared, dietary of prophylactic insulin treatment was introduced. 152 patients were involved in the screening program. 26 patients had gestational diabetes or impaired glucose tolerance. The glucose tolerance test curve was "stretched" in 81 patients. Early screening and management of pregnant women with maternal historical risk factors is emphasised from the view of diminishing complications, especially the frequency of macrosomia.
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Gestational diabetes mellitus (GDM) is defined as glucose intolerance, which is first detected during pregnancy. In the current study, we evaluated whether a first trimester 75 g oral glucose tolerance test (oGTT) is useful in stratifying pregnant women at high risk.
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A screening test for gestational diabetes should be capable of identifying for definitive (glucose tolerance) testing a large proportion of women who have the disease (sensitivity), while not identifying women for definitive testing who do not have the disease (specificity). Methods of screening include selecting patients with historical risk factors, hemoglobin A1c, fasting glucose concentrations, and the 50 g 1-hour glucose-screening test. Glucose concentrations with the latter vary with time of day and time after the last meal, and are poorly reproducible. Interposing a screening test prior to glucose tolerance testing trades ease of administration and reduced costs for the possibility of not identifying some women who have gestational diabetes.
Screening test
Glucose tolerance test
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