HealthDay News – 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 January 25 in BJOG: An International Journal of Obstetrics & Gynaecology.

J. Ryser Rüetschi, from the University Hospitals of Geneva, and colleagues collected 2298 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 mmol/L 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%. Among 251 women with gestational diabetes, fasting glycemia was ≥5.1, between 4.4 mmol/L and <5.1 mmol/L, and <4.4 mmol/L in 47.4%, 31.1%, and 21.5%, respectively. The sensitivity was 78.5% with performance of the complete test only in women with fasting glycemia between 4.4 mmol/L and <5.1 mmol/L; this would avert glucose loading in 63.8% of women.


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

Reference

Rüetschi JR, Jornayvaz FR, Rivest R, Hun EA, Irion O, Boulvain M. Fasting glycemia to simplify screening for gestational diabetes. BJOG. 2016. doi: 10.1111/1471-0528.13857.