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Contribution of a positive third-hour value in 100-g oral glucose tolerance test to the diagnosis of gestational diabetes
Nazan Usal TarhanDepartment of Obstetrics and Gynecology, University of Health Sciences, Turkey. Istanbul Zeynep Kamil Maternity and Children’s Diseases Health Training and Research Center, Istanbul, TurkeyINTRODUCTION: The aim of this study was to investigate the proportion of pregnant women whose diagnosis was confirmed with the first three measurements of the 100-g oral glucose tolerance test (OGTT) in the two-step approach used for diagnosing gestational diabetes mellitus (GDM).
METHODS: This descriptive study was conducted from May to June 2022 at Zeynep Kamil Women and Children Diseases Hospital. The results of pregnant women who underwent the 100-g OGTT between 2017 and 2021 were evaluated retrospectively. Blood glucose levels at fasting, 1-hour, 2-hour, and 3-hour intervals were assessed using the Carpenter and Coustan criteria. The frequencies of women for whom the first three values were adequate, those for whom the fourth value was required for GDM diagnosis, and those with single-value positivity were determined.
RESULTS: The test could not be completed in 91 (5.2%) pregnant women due to vomiting during the procedure. Gestational diabetes was diagnosed in 410 of the 1656 pregnant women (24.8%). While fasting, 1-hour, and 2-hour values were sufficient for diagnosis in 388 (94.6%) of the 410 women, 3-hour values were required in 22 (5.4%). A single value above the threshold was observed in 22.4% of pregnant women.
DISCUSSION AND CONCLUSION: The first three readings of the 100-g OGTT may be sufficient to diagnose GDM in the vast majority of cases. Reducing test duration can increase patient comfort and lead to savings in both time and resources. Analyzing test results and omitting subsequent steps when the diagnosis is already confirmed could be a viable approach.
Manuscript Language: English
