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. 2023 Nov:205:110952.
doi: 10.1016/j.diabres.2023.110952. Epub 2023 Oct 13.

Use of fasting plasma glucose to determine the approach for diagnosing gestational diabetes mellitus

Boyd E Metzger  1 ; HAPO [2], HAPO Follow-Up Study [8] Cooperative Research Groups  2 ; Alan Kuang  2 , William L Lowe Jr  2 , Denise M Scholtens  2 , Lynn P Lowe  2 , Alan R Dyer  2
Affiliations

Use of fasting plasma glucose to determine the approach for diagnosing gestational diabetes mellitus

Boyd E Metzger et al. Diabetes Res Clin Pract. 2023 Nov.

Abstract

Aims: Estimate the impact of OGTTs only on women with a screening FPG of 4.5-5.0 mmol/L using data from HAPO.

Methods: HAPO participants had 75-g OGTTs (24-32 weeks' gestation). At follow-up, children had adiposity assessed (overweight/obesity, obesity) and mothers and children had OGTTs. GDM was defined retrospectively using IADPSG criteria. Odds for neonatal (birthweight, percent neonatal fat, sum of skinfolds, cord C-peptide > 90th percentiles) and follow-up outcomes were assessed in those with HAPO FPG ≤ 4.4 or > 4.4 mmol/L and GDM or no GDM focusing on women with FPG > 4.4 and no GDM (Group 3) vs women with GDM and FPG ≤ 4.4 (Group 2).

Results: This strategy would miss a diagnosis of GDM in 14.7%. Odds for neonatal outcomes in Groups 2 and 3 were not different (ORs: 1.14 to 1.29). Odds at follow-up for type 2 diabetes and disorders of glucose metabolism in mothers were higher in Group 2 (ORs: 3.51, 2.57). Odds for childhood impaired glucose tolerance or adiposity outcomes were not different for Groups 2 and 3.

Conclusions: HAPO mothers whose GDM diagnosis would be missed were not at greater risk for adverse neonatal and childhood outcomes than mothers with FPG of 4.5-5.0 without GDM.

Keywords: Fasting plasma glucose; Gestational diabetes mellitus; Perinatal outcomes.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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