TY - JOUR
T1 - Gestational Diabetes Mellitus
T2 - Using the Fasting Plasma Glucose Level to Simplify the International Association of Diabetes and Pregnancy Study Groups Diagnostic Algorithm in an Adult South Asian Population
AU - Agarwal, Mukesh M.
AU - Punnose, John
AU - Sukhija, Komal
AU - Sharma, Asha
AU - Choudhary, Naimaa K.
N1 - Publisher Copyright:
© 2017 Diabetes Canada
PY - 2018/10
Y1 - 2018/10
N2 - Objectives: To evaluate the value of the fasting plasma glucose (FPG) level for simplifying the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic algorithm of gestational diabetes mellitus (GDM) in a South Asian population. Methods: In 6,520 pregnant women undergoing universal screening with the 75 g oral glucose tolerance test (OGTT), the area under receiver operating characteristic curve was used to determine the overall FPG performance to detect GDM (IADPSG criteria). Specifically, 2 different FPG thresholds of the OGTT were used to rule in and rule out GDM so as to decrease the need for the cumbersome OGTT. Results: GDM was present in 1,193 (18.3%) women. The FPG 1) area under receiver operating characteristic curve (95% CI) was 0.909 (0.898 to 0.920); 2) threshold of ≥5.1 mmol/L independently could rule in GDM in 708 (10.9%) women (100% specificity); 3) threshold of <4.3 mmol/L independently could rule out GDM in an additional 2,389 (36.6%) women (95.6% sensitivity). Conclusions: By circumventing nearly one half the OGTTs, an initial FPG can simplify the onerous GDM diagnostic IADPSG algorithm in this population parochially and in countries with large South Asian immigrant populations—without compromising medical care.
AB - Objectives: To evaluate the value of the fasting plasma glucose (FPG) level for simplifying the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic algorithm of gestational diabetes mellitus (GDM) in a South Asian population. Methods: In 6,520 pregnant women undergoing universal screening with the 75 g oral glucose tolerance test (OGTT), the area under receiver operating characteristic curve was used to determine the overall FPG performance to detect GDM (IADPSG criteria). Specifically, 2 different FPG thresholds of the OGTT were used to rule in and rule out GDM so as to decrease the need for the cumbersome OGTT. Results: GDM was present in 1,193 (18.3%) women. The FPG 1) area under receiver operating characteristic curve (95% CI) was 0.909 (0.898 to 0.920); 2) threshold of ≥5.1 mmol/L independently could rule in GDM in 708 (10.9%) women (100% specificity); 3) threshold of <4.3 mmol/L independently could rule out GDM in an additional 2,389 (36.6%) women (95.6% sensitivity). Conclusions: By circumventing nearly one half the OGTTs, an initial FPG can simplify the onerous GDM diagnostic IADPSG algorithm in this population parochially and in countries with large South Asian immigrant populations—without compromising medical care.
KW - International Association of Diabetes and Pregnancy Study Groups (IADPSG)
KW - diagnosis
KW - fasting plasma glucose
KW - gestational diabetes
KW - screening
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U2 - 10.1016/j.jcjd.2017.12.009
DO - 10.1016/j.jcjd.2017.12.009
M3 - Article
AN - SCOPUS:85043458817
SN - 1499-2671
VL - 42
SP - 500
EP - 504
JO - Canadian Journal of Diabetes
JF - Canadian Journal of Diabetes
IS - 5
ER -