The role of preanalytical glycolysis in the diagnosis of gestational diabetes mellitus in obese women

Impact of Implementing Preanalytical Laboratory Standards on the Diagnosis of Gestational Diabetes Mellitus: A Prospective Observational Study

“…This is consistent with the findings we recently reported in a smaller cohort of obese women being screened for GDM (18 ). These findings raise the possibility that suboptimal implementation of measures to prevent glycolysis is causing GDM to be underdiagnosed, with potentially serious clinical consequences.…”

“…In 24 women who had a fasting glucose result in early pregnancy, the diagnosis of GDM could be made in 16 (66.7%) if the ADA standard was implemented compared with 7 (29.2%) if it was not (P Ͻ 0.01) (18 ). In another cohort (n ϭ 24) who had an oral glucose tolerance test (OGTT) at 24 -32 weeks' gestation, the diagnosis of GDM could be made in 13 (54.2%) if the ADA standard was implemented compared with 4 (16.7%) if it was not (P Ͻ 0.001) (18 ).…”

“…In 24 women who had a fasting glucose result in early pregnancy, the diagnosis of GDM could be made in 16 (66.7%) if the ADA standard was implemented compared with 7 (29.2%) if it was not (P Ͻ 0.01) (18 ). In another cohort (n ϭ 24) who had an oral glucose tolerance test (OGTT) at 24 -32 weeks' gestation, the diagnosis of GDM could be made in 13 (54.2%) if the ADA standard was implemented compared with 4 (16.7%) if it was not (P Ͻ 0.001) (18 ). Because obesity is associated with higher leukocyte counts, and because glycolysis is affected by leukocyte count, we further investigated if these findings could be replicated in all women being screened selectively for GDM (19,20 ).…”

“…We recently reported on 2 cohorts of obese women and compared the strict implementation of ADArecommended preanalytical glucose sample management with usual hospital practice (18 ). In 24 women who had a fasting glucose result in early pregnancy, the diagnosis of GDM could be made in 16 (66.7%) if the ADA standard was implemented compared with 7 (29.2%) if it was not (P Ͻ 0.01) (18 ).…”

Racial and Ethnic Disparities in Hospital Readmissions After Delivery

“…3 When we applied the IADPSG diagnostic criteria and these updated laboratory recommendations, we found that 54% of obese women and 38.1% of women selectively screened had GDM. 4,5 Thus, it is possible that the high rate of 27% reported from California using the IADPSG criteria may be an underestimation of the incidence of GDM.…”