Fasting glycemia screening is alternative to 75-g GTT for GDM

(HealthDay)—Screening for gestational diabetes with fasting glycemia seems to be an acceptable alternative to universal screening with the complete 75-gram glucose tolerance test, according to a study published online Jan. 25 in BJOG: An International Journal of Obstetrics & Gynaecology.

J. Ryser Rüetschi, from the University Hospitals of Geneva, and colleagues collected 2,298 complete 75-g glucose tolerance tests from pregnant women at 24 to 28 weeks of gestation. They simulated stopping the test if fasting glycemia was <4.4 or ≥5.1 mmol/L, thereby avoiding glucose loading and further glycemia.

The researchers found that within the population, the prevalence of gestational diabetes was 10.9 percent. Among 251 women with gestational diabetes, fasting glycemia was ≥5.1, between 4.4 and <5.1, and <4.4 mmol/L in 47.4, 31.1, and 21.5 percent, respectively. The sensitivity was 78.5 percent with performance of the complete test only in women with fasting glycemia between 4.4 and <5.1 mmol/L; this would avert glucose loading in 63.8 percent of women.

"Screening with fasting glycemia is an attractive alternative to universal screening with the complete 75-g glucose tolerance test," the authors write. "This strategy is, however, slightly less sensitive than previously reported in higher-risk populations."

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