Non-fasting OGTT versus Fasting OGTT for screening of Hyperglycaemia in Pregnancy (HIP)

Masood, Shabeen Naz; Lakho, Nusrat; Saeed, Saira; Masood, Yasir

doi:10.12669/pjms.37.4.3979

Cited by 3 publications

(2 citation statements)

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“…The research field has recognized this limitation and called for establishing metabolomics consortiums (e.g., COMETS) to aggregate datasets and resources [ 25 ]. Second, although we collected fasting plasma samples in both the first and the third trimesters, no fasting plasma sample was collected in the second trimester [ 40 ]. Future studies collecting fasting blood samples in the second trimester may provide a novel perspective on the metabolic biomarkers of GWG.…”

Section: Discussionmentioning

confidence: 99%

Metabolome-Wide Associations of Gestational Weight Gain in Pregnant Women with Overweight and Obesity

et al. 2022

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Excessive gestational weight gain (GWG) is associated with adverse pregnancy outcomes. This metabolome-wide association study aimed to identify metabolomic markers for GWG. This longitudinal study included 39 Black and White pregnant women with a prepregnancy body mass index (BMI) of ≥ 25 kg/m2. Untargeted metabolomic profiling was performed using fasting plasma samples collected at baseline (mean: 12.1 weeks) and 32 weeks of gestation. The associations of metabolites at each time point and changes between the two time points with GWG were examined by linear and least absolute shrinkage and selection operator (LASSO) regression analyses. Pearson correlations between the identified metabolites and cardiometabolic biomarkers were examined. Of the 769 annotated metabolites, 88 metabolites at 32 weeks were individually associated with GWG, with four (phosphatidylcholine (PC) 34:4, triacylglycerol (TAG) 52:6, arachidonic acid, isoleucine) jointly associated with GWG (area under the receiver operating characteristic curve (AUC) for excessive GWG: 0.80, 95% CI: 0.67, 0.93). No correlations were observed between the 88 metabolites and insulin, C-peptide, and high-sensitivity C-reactive protein at 32 weeks. Twelve metabolites at baseline (AUC for excessive GWG: 0.80, 95% CI: 0.62, 0.99) and three metabolite changes (AUC for excessive GWG: 0.73, 95% CI: 0.44, 1.00) were jointly associated with GWG. We identified novel metabolites in the first and third trimesters associated with GWG, which may shed light on the pathophysiology of GWG.

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Section: Discussionmentioning

confidence: 99%

Metabolome-Wide Associations of Gestational Weight Gain in Pregnant Women with Overweight and Obesity

et al. 2022

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“…3 According to IADPSG and WHO, a fasting OGTT is recommended for diagnosis of GDM but is associated with inconvenience, requires two to three times withdrawing of blood, has increased cost, and is not tolerated well by pregnant women as likely to cause nausea and vomiting. 12 The glycosylated hemoglobin HbA1c is universally accepted test, approved by National Health and Medical Research Council, to diagnose Type 2 DM, a one-time measure to ascertain plasma glucose levels, less invasive and with better reliability and less variation. It has been considered to diagnose GDM in many studies previously but till date not accepted because of various factors e.g., pregnancy associated anemia and a range of difference in values between GDM and pregnancy without diabetes.…”

Section: Introductionmentioning

confidence: 99%

HbA1c as an early diagnostic marker in gestational diabetes mellitus.

Shabana Abbas,

Mehnaz Khattak,

Sanober Hameed

et al. 2024

TPMJ

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Objective: To assess the effectiveness of HbA1c as an indicator of Gestational Diabetes mellitus(GDM). Study Design: Prospective Cases Control study. Setting: Fauji Foundation Hospital Rawalpindi. Period: March 2022 to Oct 2022. Methods: All pregnant females older than 18 years of age having pregnancy confirmed by gynecologist in 1st trimester were included. A 5ml blood sample was obtained from each case to evelaute the HbA1c level. Oral glucose tolerance test (OGTT) was performed on both groups at conception to 12 weeks (1st trimester) as well as at 12 to 24 weeks of gestation (2nd trimester) to evaluate correlation between OGTT and HbA1c test. All the females suffering from GDM were taken in cases group and comparatively in equal number non GDM pregnant women were taken in control group. All the relevant information was collected via study proforma and SPSS version 26 was used for analysis. Results: The number of females suffering from GDM was 45 in number and we took 45 pregnant females as control group. Average level of HbA1c in women with GDM (test group) was higher than in women with Non-GDM (control group). Patients having age groups 35-39 showing greater prevalence of gestational diabetes with 73.2% sensitivity and 66.7% specificity at a cut-off value of 5.6% (31 mmol/mol) for GDM diagnosis. Conclusion: The findings reveal significantly elevated HbA1c levels during both the first and second trimesters in individuals diagnosed with GDM, with a test specificity of 95%. This underscores its ability to accurately pinpoint individuals who truly have GDM. However, HbA1c is observed as a valuable diagnostic tool for the early detection of GDM.

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Prevalence of gestational diabetes mellitus in Pakistan: a systematic review and meta-analysis

Adnan,

Aasim

2024

BMC Pregnancy Childbirth

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Background A variety of screening tools and criteria are used for the diagnosis of gestational diabetes mellitus (GDM). As a result, the prevalence rate of GDM varied from 4.41% to 57.90% among studies from Pakistan. Beside this disagreement, similar multi-centric studies, community surveys and pooled evidence were lacking from the country. Therefore, this first systematic review and meta-analysis aimed to measure the overall and subgroup pooled estimates of GDM and explore the methodological variations among studies for any inconsistency. Methods Using the PRISMA guidelines, seventy studies were identified from PubMed, ScienceDirect, Google Scholar and PakMediNet database. Of them, twenty-four relevant studies were considered for systematic review and nine eligible studies selected for meta-analysis. AXIS was used for measuring quality of reporting, I^2 statistics for heterogeneity among studies and subgroups, funnel plot for reporting potential publication bias and forest plot for presenting pooled estimates. Results The pooled sample of nine studies was 27,034 (126 – 12,450) pregnant women, of any gestational age, from all four provinces of Pakistan. Overall pooled estimate of GDM was 16.7% (95% CI 13.1 – 21.1). The highest subgroup pooled estimate of GDM observed in studies from Balochistan (35.8%), followed by Islamabad (23.9%), Khyber Pakhtunkhwa (17.2%), Sindh (13.2%), and Punjab (11.4%). The studies that adopted 75g 2-h OGTT had a little lower pooled estimate (16.3% vs. 17.3%); and that adopted diagnostic cut-off values [≥ 92 (F), ≥ 180 (1-h) and ≥ 153 (2-h)] had a greater pooled estimate (25.4% vs. 15.8%). The studies that adopted Carpenter criteria demonstrated the highest subgroup pooled estimate of GDM (26.3%), after that IADPSG criteria (25.4%), and ADA criteria (23.9%). Conclusions Along with poor quality of reporting, publishing in non-indexed journals and significant disagreement between studies, the prevalence rate of GDM is high in Pakistan. Consensus building among stakeholders for recommended screening methods; and continuous medical education of the physicians are much needed for a timely detection and treatment of GDM.

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Non-fasting OGTT versus Fasting OGTT for screening of Hyperglycaemia in Pregnancy (HIP)

Cited by 3 publications

References 24 publications

Metabolome-Wide Associations of Gestational Weight Gain in Pregnant Women with Overweight and Obesity

Metabolome-Wide Associations of Gestational Weight Gain in Pregnant Women with Overweight and Obesity

HbA1c as an early diagnostic marker in gestational diabetes mellitus.

Prevalence of gestational diabetes mellitus in Pakistan: a systematic review and meta-analysis

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