Gestational diabetes & diabetes in pregnancy
The utility of early gestational OGTT and biomarkers for the development of gestational diabetes mellitus: an international prospective multicentre cohort study
Authors' conclusion
Although the accurate diagnosis of GDM before 24 weeks remains an ongoing discussion, dynamically assessed glucose concentrations during an early OGTT were closely associated with impaired glucose homeostasis and showed good predictive accuracy for later development of GDM as well as the requirement for insulin. These findings may be used to develop a protocol to distinguish between low- and high-risk mothers.
Study context
- Population
- Pregnant women in six Central European centres; early OGTT and biomarkers at median gestational age 13.4 weeks (IQR 12.7–14.1)
- Participants
- 657 women
- Outcome
- Predictive performance of first-trimester OGTT and biomarkers for later GDM
Methodological detailsinternational, multicentre, blinded 75 g OGTT
- International
- Multicentre
- Blinded 75 g OGTT
Main finding
As reported in the abstract
Developed gestational diabetes mellitus (GDM)
83
12.6%
AUC, OGTT glucose at fasting
0.68
AUC, OGTT glucose at 60 min
0.74
AUC, OGTT glucose at 120 min
0.72
Observational data: associations, not effects.
Further findings
Biomarkers
- Some biomarkers showed significant but modest predictive accuracy
Glucose homeostasis and insulin requirement
- Early OGTT glucose associated with impaired insulin sensitivity, beta cell dysfunction and insulin requirement in later pregnancy
Original publication
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