The Role of Untimed Blood Glucose in Screening for Gestational Diabetes Mellitus in a High Prevalent Diabetic Population
Open accessAbstract
Global prevalence increase of diabetes type 2 and gestational diabetes (GDM) has led to increased awareness and screening of pregnant women for GDM. Ideally screening for GDM should be done by an oral glucose tolerance test (oGTT), which is laborious and time consuming. A randomized glucose test incorporated with anthropomorphic characteristics may be an appropriate cost-effective combined clinical and biochemical screening protocol for clinical practice as well as cutting down on oGTTs. A retrospective observational study was performed on a randomized sample of pregnant women who required an OGTT during their pregnancy. Biochemical and anthropomorphic data along with obstetric outcomes were statistically analyzed. Backward stepwise logistic regression and receiver operating characteristics curves were used to obtain a suitable predictor for GDM without an oGTT and formulate a screening protocol. Significant GDM predictive variables were fasting blood glucose (p=0.0001) and random blood glucose (p=0.012). Different RBG and FBG cutoff points with anthropomorphic characteristics were compared to carbohydrate metabolic status to diagnose GDM without oGTT, leading to a screening protocol. A screening protocol incorporating IADPSG diagnostic criteria, BMI, and different RBG and FBG criteria would help predict GDM among high-risk populations earlier and reduce the need for oGTT test.
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In Malta, Cuschieri et al. performed universal screening and GDM was diagnosed in 136 cases (33.9%) using OGTT according to IADPSG criteria.
“Cuschieri et al. decided to perform universal screening in their study, and GDM was diagnosed in 136 cases (33.9%) using the OGTT according to the IADPSG criteria [201].”
From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [201]
Materials and Methods reports that 136 of 401 women (33.9%) had GDM confirmed by OGTT under IADPSG criteria. It says all women attending a first antenatal visit were invited, but only about 10% of the obstetric population underwent OGTT; the Discussion describes the participants as a convenience sample with possible selection bias. Calling the study universal screening therefore overstates what was performed. (LLM, conf=0.90)
Experimental — accuracy not yet measuredIn Malta, screening is based on IADPSG guidelines, but only high-risk patients are qualified for an OGTT between 24 and 28 weeks.
“In Malta screening is based on the IADPSG guidelines, but only high-risk patients are qualified for an OGTT test between 24 and 28 weeks of gestation [201].”
From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [201]
The Introduction (page unavailable) says Malta primarily identifies high-risk women for GDM screening and increasingly accepts the IADPSG diagnostic criterion. It does not say that only high-risk women qualify for an OGTT at 24–28 weeks; the Materials and Methods instead say the study invited all women at their first antenatal visit and included both high- and low-risk participants. (LLM, conf=0.88)
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Cites
Lawrence, J. M., Contreras, R., Chen, W., & Sacks, D. A. (2008) · Diabetes Care · doi:10.2337/dc07-2345 · Cited by 658 · see citing works
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Evolution of Gestational Diabetes Mellitus across Continents in 21st Century
Dłuski, D. F., Ruszała, M., Rudziński, G., Pożarowska, K., Brzuszkiewicz, K., & Leszczyńska-Gorzelak, B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315804 · Cited by 41 · see citing works
- Authors
- Cuschieri, S., Craus, J., & Savona-Ventura, C.
- Affiliations
- University of Malta (MT)
- Mater Dei Hospital (MT)
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Msida MSD 2090, Malta
- Corresponding author
- Cuschieri, Sarah
- ORCID
- Cuschieri, Sarah
- Venue
- Scientifica
- Publisher
- Hindawi Limited
- Published
- 2016
- Volume
- 2016
- Pages
- 1-6
- ISSN
- 2090-908X (ISSN-L)
- PMC
- PMC4779531
- OpenAlex
- W2284921402
- Cited by
- 3
- References
- 1
- Citations by year
- 2022: 1 · 2020: 1 · 2016: 1
- FWCI
- 0.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientifica (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- OAR@UM (University of Malta) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Master it! Scholarship Scheme
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- gestational diabetes mellitus, random blood glucose, fasting blood glucose, GDM screening, oral glucose tolerance test, anthropometric predictors, body mass index, IADPSG criteria, high-risk pregnant women, carbohydrate metabolism
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