Screening for gestational diabetes: examining a breakfast meal test

Figures & data

Table 1: Risk factors to identify screening candidates for gestational diabetes

Previous gestational diabetes

Previous unexplained intra-uterine death

Previous macrosomic baby > 4.5 kg

Body mass index (BMI) at booking > 40 kg/m^2

Maternal age > 40 years

Family history (first-degree relative with diabetes)

Family origin with a high prevalence of diabetes (Asiatic)

Acanthosis nigricans

Polycystic ovarian syndrome

Table 2: Descriptive baseline data

Age (years)	31 (19–42)
Gravidity	3 (1–5)
Parity	2 (0–3)
BMI (kg/m^2)	36 (21–49)

Note: BMI = body mass index.

Table 3: Examples of certain specific patient-provided breakfast meal tests

Centile	Fluids	Solids	Carb (g)*
Lowest	Tea 1 × cup + milk + 3 × sugars	None	15
25th centile	1 × cup low-fat milk	2 × Weet-Bix® bars	53
50th centile	330 ml Stoney® ginger beer	2 × small apples	71
75th centile	500 ml fruit juice	2 × medium apples	101
Highest	500 ml fruit juice	1 × steak pie; 1 × mince samosa	145

* Carbohydrate quantity in grams.

Figure 1: Carbohydrate quantity (g) of 50 breakfast meal tests.

Table 4: Comparison of the macronutrient distribution of certain meal tests*

Meal test	Protein	Fat	Carbohydrate	Carbohydrate type
OGGT	–	–	75 g	100% glucose
CookieHarano et al. 2006^20	7 g (5%)	25 g (41%)	75 g (54%)	85% starch; 15% maltose
Oral shakeTraub et al. 2012^21	30 g (20%)	20 g (30%)	75 g (50%)	100% glucose
MuffinTraub et al. 2012^21	6 g (6%)	18 g (40%)	56 g (55%)	Not given
WafersWolever et al. 1998^19	12 g (14%)	11 g (28%)	50 g (58%)	82% starch; 18% sugars
10 candy twists Racusin et al. 2015^22	2 g (4%)	1 g (5%)	50 g (92%)	Mostly sugars

* Macronutrient distribution is given as a percentage of the total energy.

Harano Y, Miyawaki T, Nabiki J, et al. Development of cookie test for the simultaneous determination of glucose intolerance, hyperinsulinemia, insulin resistance and postprandial dyslipidemia. Endocr J. 2006;53(2):173–80.10.1507/endocrj.53.173

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Racusin DA, Antony K, Showalter L, et al. Candy twists as an alternative to the glucola beverage in gestational diabetes mellitus screening. Am J Obstet Gynecol. 2015;212:522.e1–5.

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