Diagnosis of gestational diabetes mellitus using a modified 100 g oral glucose tolerance test

Abstract

Objective: To determine an optimal cutoff level of a modified 100 g oral glucose tolerance test (OGTT) with its diagnostic performance for gestational diabetes mellitus (GDM).Study Design: Obstetric records of 909 women who had undergone a 100 g OGTT were reviewed. A modified 100 g OGTT referred to a test using a summation of 1 and 2 h plasma glucose levels after 100 g glucose ingestion. The sensitivity and specificity of this summed glucose at various cutoff levels for diagnosing GDM were obtained. A receiver operating characteristic curve was then constructed to determine the optimal value for a GDM diagnosis.Result: Based on a conventional 100 g OGTT, GDM was detected in 155 women (17.1%). Using a modified 100 g OGTT, the optimal summed glucose value for GDM diagnosis was X341 mg 100 ml À1 which yielded 93.5% sensitivity and 95.2% specificity. Conclusion:The modified 100 g OGTT demonstrated high diagnostic performance for GDM, with advantages over a conventional 100 g OGTT in terms of less time consuming, lower cost and fewer number of venipuncture.

Diagnosis of gestational diabetes

“…Phaloprakarn and Tangjitgamol also suggested a modified 100-g OGTT consisting of a summation of 1- and 2-hour values, and they reported that the optimal value of this test was 341 mg/dL with 93.5% of sensitivity and 95.2% of specificity. [ 13 ] Additionally, previous studies on 100-g OGTT suggested that a 2-hour 100-g OGTT (0-, 1-, and 2-hour) could be a reasonable option based on the result that showed 89.5% to 93.1% of the GDM cases could be detected by 2-hour 100-g OGTT. [ 13 , 14 ] In our study, 39 out of 93 (41.9%) of the GDM cases could be confirmed only by 0- and 1-hour samplings based on C&C criteria.…”

“…[ 13 ] Additionally, previous studies on 100-g OGTT suggested that a 2-hour 100-g OGTT (0-, 1-, and 2-hour) could be a reasonable option based on the result that showed 89.5% to 93.1% of the GDM cases could be detected by 2-hour 100-g OGTT. [ 13 , 14 ] In our study, 39 out of 93 (41.9%) of the GDM cases could be confirmed only by 0- and 1-hour samplings based on C&C criteria. Besides, a total of 146 of 207 (70.5%) of gravidas who were required beyond 2-hour sampling could be diagnosed with or excluded for GDM without 3-hour blood sampling (data not shown).…”

“…Unlike these studies, we tried to simplify the diagnostic step rather than omitting a 100-g diagnostic OGTT. Phaloprakarn and Tangjitgamol also suggested a modified 100-g OGTT consisting of a summation of 1- and 2-hour values, and they reported that the optimal value of this test was 341 mg/dL with 93.5% of sensitivity and 95.2% of specificity [13] . Additionally, previous studies on 100-g OGTT suggested that a 2-hour 100-g OGTT (0-, 1-, and 2-hour) could be a reasonable option based on the result that showed 89.5% to 93.1% of the GDM cases could be detected by 2-hour 100-g OGTT [13,14] .…”