Abstract:
Background: The diagnosis of gestational diabetes
mellitus (GDM) is mainly based on oral glucose
tolerance test (OGTT) in Sri Lankan clinical setting.
The present study was to assess the diagnostic
significance of individual glucose values in 75g
OGTT in a group of pregnant mothers, to modify
the test procedure to make it more convenient and
cost-effective and to identify the associated risk
factors for GDM.
Methods: A total of 150 pregnant women within
the second trimester and attending the antenatal
clinics at Teaching Hospital Mahamodara were
recruited for the study. Data collection was carried
out via an interviewer-administered questionnaire
followed by retrieval of laboratory data on OGTT.
Results: Seventeen pregnant women (11.33%) were
diagnosed with GDM by OGTT based on the WHO
criteria. Diagnosis was based on either fasting or
2-hour glucose values alone or by increased levels
in more than one of those parameters. None of
them were diagnosed based on the 1-hour glucose
value alone. The AUC values were 0.951 (0.884,
1.000), 0.829 (0.715, 0.942) and 0.859 (0.776,
0.943) respectively for fasting, 1-hour and 2-hour
glucose concentrations (CI 95%). GDM was asso ciated with uncontrolled sweet consumption
(
2=5.86, p=0.015) and no association was
observed with reference to maternal age, parity, BMI,
positive family history of diabetes, and prior history
of GDM or diabetes mellitus.Conclusion: Fasting and 2-hour plasma glucose
values have higher diagnostic accuracy over 1-hour
glucose values and the findings suggest the
performance of fasting and 2-hour samples alone
in the standard 75g OGTT procedure for the
diagnosis of GDM
