Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes
In order to evaluate the performance of a 1-h 75-g oral glucose tolerance test (OGTT) for the diagnosis of gestational diabetes mellitus (GDM), a cohort of 4998 women, 20 years or older, without previous diabetes being treated in prenatal care clinics in Brazil answered a questionnaire and performed...
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| Format: | Article |
| Language: | English |
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Associação Brasileira de Divulgação Científica
2008-08-01
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| Series: | Brazilian Journal of Medical and Biological Research |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2008000800008 |
| _version_ | 1818193386907107328 |
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| author | M.A.A. Campos A.A.J. Reichelt C. Façanha A.C. Forti M.I. Schmidt |
| author_facet | M.A.A. Campos A.A.J. Reichelt C. Façanha A.C. Forti M.I. Schmidt |
| author_sort | M.A.A. Campos |
| collection | DOAJ |
| description | In order to evaluate the performance of a 1-h 75-g oral glucose tolerance test (OGTT) for the diagnosis of gestational diabetes mellitus (GDM), a cohort of 4998 women, 20 years or older, without previous diabetes being treated in prenatal care clinics in Brazil answered a questionnaire and performed a 75-g OGTT including fasting, 1-h and 2-h glucose measurements between their 24th and 28th gestational weeks. Pregnancy outcomes were transcribed from medical registries. GDM was defined according to WHO criteria (fasting: ≥126 mg/dL; 2-h value: ≥140 mg/dL) and macrosomia as a birth weight equal to or higher than 4000 g. Areas under the receiver operator characteristic curve (AUC) were compared and diagnostic properties of various cut-off points were evaluated. The AUCs for the prediction of macrosomia were 0.606 (0.572-0.637) for the 1-h and 0.589 (0.557-0.622) for the 2-h plasma glucose test. Similar predictability was demonstrable regarding combined adverse outcomes: 0.582 (0.559-0.604) for the 1-h test and 0.572 (0.549-0.595) for the 2-h test. When the 1-h glucose test was evaluated against a diagnosis of GDM defined by the 2-h glucose test, the AUC was 0.903 (0.886-0.919). The cut-off point that maximized sensitivity (83%) and specificity (83%) was 141 mg/dL, identifying 21% of the women as positive. A cut-off point of 160 mg/dL, with lower sensitivity (62%), had higher specificity (94%), labeling 8.6% as positive. Detection of GDM can be done with a 1-h 75-g OGTT: the value of 160 mg/dL has the same diagnostic performance as the conventional 2-h value (140 mg/dL). The simplification of the test may improve coverage and timing of the diagnosis of GDM. |
| first_indexed | 2024-12-12T00:45:35Z |
| format | Article |
| id | doaj.art-1a680f0aa9a749dc999f988d279407c3 |
| institution | Directory Open Access Journal |
| issn | 0100-879X 1414-431X |
| language | English |
| last_indexed | 2024-12-12T00:45:35Z |
| publishDate | 2008-08-01 |
| publisher | Associação Brasileira de Divulgação Científica |
| record_format | Article |
| series | Brazilian Journal of Medical and Biological Research |
| spelling | doaj.art-1a680f0aa9a749dc999f988d279407c32022-12-22T00:44:08ZengAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological Research0100-879X1414-431X2008-08-01418684688Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetesM.A.A. CamposA.A.J. ReicheltC. FaçanhaA.C. FortiM.I. SchmidtIn order to evaluate the performance of a 1-h 75-g oral glucose tolerance test (OGTT) for the diagnosis of gestational diabetes mellitus (GDM), a cohort of 4998 women, 20 years or older, without previous diabetes being treated in prenatal care clinics in Brazil answered a questionnaire and performed a 75-g OGTT including fasting, 1-h and 2-h glucose measurements between their 24th and 28th gestational weeks. Pregnancy outcomes were transcribed from medical registries. GDM was defined according to WHO criteria (fasting: ≥126 mg/dL; 2-h value: ≥140 mg/dL) and macrosomia as a birth weight equal to or higher than 4000 g. Areas under the receiver operator characteristic curve (AUC) were compared and diagnostic properties of various cut-off points were evaluated. The AUCs for the prediction of macrosomia were 0.606 (0.572-0.637) for the 1-h and 0.589 (0.557-0.622) for the 2-h plasma glucose test. Similar predictability was demonstrable regarding combined adverse outcomes: 0.582 (0.559-0.604) for the 1-h test and 0.572 (0.549-0.595) for the 2-h test. When the 1-h glucose test was evaluated against a diagnosis of GDM defined by the 2-h glucose test, the AUC was 0.903 (0.886-0.919). The cut-off point that maximized sensitivity (83%) and specificity (83%) was 141 mg/dL, identifying 21% of the women as positive. A cut-off point of 160 mg/dL, with lower sensitivity (62%), had higher specificity (94%), labeling 8.6% as positive. Detection of GDM can be done with a 1-h 75-g OGTT: the value of 160 mg/dL has the same diagnostic performance as the conventional 2-h value (140 mg/dL). The simplification of the test may improve coverage and timing of the diagnosis of GDM.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2008000800008Gestational diabetesDiagnosisMacrosomia1-h OGTTSensitivitySpecificity |
| spellingShingle | M.A.A. Campos A.A.J. Reichelt C. Façanha A.C. Forti M.I. Schmidt Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes Brazilian Journal of Medical and Biological Research Gestational diabetes Diagnosis Macrosomia 1-h OGTT Sensitivity Specificity |
| title | Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes |
| title_full | Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes |
| title_fullStr | Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes |
| title_full_unstemmed | Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes |
| title_short | Evaluation of a 1-h 75-g oral glucose tolerance test in the diagnosis of gestational diabetes |
| title_sort | evaluation of a 1 h 75 g oral glucose tolerance test in the diagnosis of gestational diabetes |
| topic | Gestational diabetes Diagnosis Macrosomia 1-h OGTT Sensitivity Specificity |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2008000800008 |
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