Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus
Abstract Background Established risk factors for Gestational Diabetes Mellitus (GDM) include age, ethnicity, family history of diabetes and previous GDM. Additional significant influences have recently been demonstrated in the literature. The oral glucose tolerance test (OGTT) used for GDM diagnosis...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-04629-8 |
| _version_ | 1811303031923277824 |
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| author | Daria Di Filippo Chloe Bell Melissa Han Yiin Chang Justine Darling Amanda Henry Alec Welsh |
| author_facet | Daria Di Filippo Chloe Bell Melissa Han Yiin Chang Justine Darling Amanda Henry Alec Welsh |
| author_sort | Daria Di Filippo |
| collection | DOAJ |
| description | Abstract Background Established risk factors for Gestational Diabetes Mellitus (GDM) include age, ethnicity, family history of diabetes and previous GDM. Additional significant influences have recently been demonstrated in the literature. The oral glucose tolerance test (OGTT) used for GDM diagnosis has sub-optimal sensitivity and specificity, thus often results in GDM misdiagnoses. Comprehensive screening of risk factors may allow more targeted monitoring and more accurate diagnoses, preventing the devastating consequences of untreated or misdiagnosed GDM. We aimed to develop a comprehensive online questionnaire of GDM risk factors and triangulate it with the OGTT and continuous glucose monitoring (CGM) parameters to better evaluate GDM risk and diagnosis. Methods Pregnant women participating in two studies on the use of CGM for GDM were invited to complete the online questionnaire. A risk score, based on published literature, was calculated for each participant response and compared with the OGTT result. A total risk score (TRS) was then calculated as a normalised sum of all risk factors. Triangulation of OGTT, TRS and CGM score of variability (CGMSV) was analysed to expand evaluation of OGTT results. Results Fifty one women completed the questionnaire; 29 were identified as ‘high-risk’ for GDM. High-risk ethnic background (p < 0.01), advanced age, a family diabetic history (p < 0.05) were associated with a positive OGTT result. The triangulation analysis (n = 45) revealed six (13%) probable misdiagnoses (both TRS and CGMSV discordant with OGTT), consisting of one probable false positive and five probable false negative by OGTT results. Conclusions This study identified pregnant women at high risk of developing GDM based on an extended evaluation of risk factors. Triangulation of TRS, OGTT and CGMSV suggested potential misdiagnoses of the OGTT. Future studies to explore the correlation between TRS, CGMSV and pregnancy outcomes as well as additional GDM pregnancy biomarkers and outcomes to efficiently evaluate OGTT results are needed. |
| first_indexed | 2024-04-13T07:39:42Z |
| format | Article |
| id | doaj.art-eaad748d795e4451bb3e1d23d21562fe |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-13T07:39:42Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-eaad748d795e4451bb3e1d23d21562fe2022-12-22T02:55:57ZengBMCBMC Pregnancy and Childbirth1471-23932022-04-0122111110.1186/s12884-022-04629-8Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitusDaria Di Filippo0Chloe Bell1Melissa Han Yiin Chang2Justine Darling3Amanda Henry4Alec Welsh5School of Women’s and Children’s Health, University of New South WalesSchool of Women’s and Children’s Health, University of New South WalesSchool of Women’s and Children’s Health, University of New South WalesDiabetes Clinic, Royal Hospital for WomenSchool of Women’s and Children’s Health, University of New South WalesSchool of Women’s and Children’s Health, University of New South WalesAbstract Background Established risk factors for Gestational Diabetes Mellitus (GDM) include age, ethnicity, family history of diabetes and previous GDM. Additional significant influences have recently been demonstrated in the literature. The oral glucose tolerance test (OGTT) used for GDM diagnosis has sub-optimal sensitivity and specificity, thus often results in GDM misdiagnoses. Comprehensive screening of risk factors may allow more targeted monitoring and more accurate diagnoses, preventing the devastating consequences of untreated or misdiagnosed GDM. We aimed to develop a comprehensive online questionnaire of GDM risk factors and triangulate it with the OGTT and continuous glucose monitoring (CGM) parameters to better evaluate GDM risk and diagnosis. Methods Pregnant women participating in two studies on the use of CGM for GDM were invited to complete the online questionnaire. A risk score, based on published literature, was calculated for each participant response and compared with the OGTT result. A total risk score (TRS) was then calculated as a normalised sum of all risk factors. Triangulation of OGTT, TRS and CGM score of variability (CGMSV) was analysed to expand evaluation of OGTT results. Results Fifty one women completed the questionnaire; 29 were identified as ‘high-risk’ for GDM. High-risk ethnic background (p < 0.01), advanced age, a family diabetic history (p < 0.05) were associated with a positive OGTT result. The triangulation analysis (n = 45) revealed six (13%) probable misdiagnoses (both TRS and CGMSV discordant with OGTT), consisting of one probable false positive and five probable false negative by OGTT results. Conclusions This study identified pregnant women at high risk of developing GDM based on an extended evaluation of risk factors. Triangulation of TRS, OGTT and CGMSV suggested potential misdiagnoses of the OGTT. Future studies to explore the correlation between TRS, CGMSV and pregnancy outcomes as well as additional GDM pregnancy biomarkers and outcomes to efficiently evaluate OGTT results are needed.https://doi.org/10.1186/s12884-022-04629-8Gestational diabetes mellitusQuestionnaireOral glucose tolerance testRisk factorsScreening, continuous glucose monitoring |
| spellingShingle | Daria Di Filippo Chloe Bell Melissa Han Yiin Chang Justine Darling Amanda Henry Alec Welsh Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus BMC Pregnancy and Childbirth Gestational diabetes mellitus Questionnaire Oral glucose tolerance test Risk factors Screening, continuous glucose monitoring |
| title | Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus |
| title_full | Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus |
| title_fullStr | Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus |
| title_full_unstemmed | Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus |
| title_short | Development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus |
| title_sort | development and evaluation of an online questionnaire to identify women at high and low risk of developing gestational diabetes mellitus |
| topic | Gestational diabetes mellitus Questionnaire Oral glucose tolerance test Risk factors Screening, continuous glucose monitoring |
| url | https://doi.org/10.1186/s12884-022-04629-8 |
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