Use of fasting plasma glucose to determine the approach for diagnosing gestational diabetes mellitus

the HAPO [2], HAPO Follow-Up Study [8] Cooperative Research Groups

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Abstract

Aims: Estimate the impact of OGTTs only on women with a screening FPG of 4.5–5.0 mmol/L using data from HAPO. Methods: HAPO participants had 75-g OGTTs (24–32 weeks’ gestation). At follow-up, children had adiposity assessed (overweight/obesity, obesity) and mothers and children had OGTTs. GDM was defined retrospectively using IADPSG criteria. Odds for neonatal (birthweight, percent neonatal fat, sum of skinfolds, cord C-peptide > 90th percentiles) and follow-up outcomes were assessed in those with HAPO FPG ≤ 4.4 or > 4.4 mmol/L and GDM or no GDM focusing on women with FPG > 4.4 and no GDM (Group 3) vs women with GDM and FPG ≤ 4.4 (Group 2). Results: This strategy would miss a diagnosis of GDM in 14.7%. Odds for neonatal outcomes in Groups 2 and 3 were not different (ORs: 1.14 to 1.29). Odds at follow-up for type 2 diabetes and disorders of glucose metabolism in mothers were higher in Group 2 (ORs: 3.51, 2.57). Odds for childhood impaired glucose tolerance or adiposity outcomes were not different for Groups 2 and 3. Conclusions: HAPO mothers whose GDM diagnosis would be missed were not at greater risk for adverse neonatal and childhood outcomes than mothers with FPG of 4.5–5.0 without GDM.

Original languageEnglish (US)
Article number110952
JournalDiabetes Research and Clinical Practice
Volume205
DOIs
StatePublished - Nov 2023

Funding

The HAPO Study was funded by from the Eunice Kennedy Shriver National Institute of Child Health and Human Development ( R01-HD-34242 and R01-HD-34243 ). The HAPO Follow-Up Study was funded by grant 1U01DK094830 from the National Institute of Diabetes, Digestive, and Kidney Diseases and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences, grant UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Keywords

  • Fasting plasma glucose
  • Gestational diabetes mellitus
  • Perinatal outcomes

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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