The importance of fasting blood glucose in screening for gestational diabetes

Abstract

Objective: To determine how well an isolated abnormal fasting blood glucose (FBG) value on the 1-step, 75-g, 2-hour glucose tolerance test (GTT) indicates significant gestational diabetes (GDM).

Methods: Retrospective cohort study, January 2011 to May 2012. Patients diagnosed by the 1-step method were assigned by their abnormal results to the isolated fasting (FBG), isolated 1-hour (1HBG), isolated 2-hour (2HBG), or multiple-value (≥2BG) group. Characteristics and outcomes were compared using ANOVA, Kruskal--Wallis, and Chi-squared tests.

Results: 324 patients were included. Compared to other groups, the FBG group (N = 23) had the highest incidence of requiring medical therapy (78.26%), mean body mass index (29.40 ± 6.20 kg/m²), and percentage of Black plus Hispanic women (60.87%).

Conclusions: Seven percent of women were diagnosed with GDM by an isolated abnormal fasting BG and have significant disease. This group should not be missed; therefore, fasting BG should be integrated into all GDM screening.

• 2-hour glucose tolerance test
• 1-step method
• 2-step method

Acknowledgements

The authors wish to acknowledge the writing assistance of Medical Editor Carolyn Waldron, MS, MA, and the analysis and advice of Biostatistician Erin Moshier, MS. The services of each were funded by the Department of Obstetrics and Gynecology.

Declaration of interest

The authors report no declarations of interest.