Evaluation of the Value of Fasting Plasma Glucose in the First Prenatal Visit to Diagnose Gestational Diabetes Mellitus in China

Author:

Zhu Wei-wei1,Yang Hui-xia1,Wei Yu-mei1,Yan Jie1,Wang Zi-lian2,Li Xue-lan3,Wu Hai-rong4,Li Nan5,Zhang Mei-hua6,Liu Xing-hui7,Zhang Hua8,Wang Yun-hui9,Niu Jian-min10,Gan Yu-jie11,Zhong Li-ruo12,Wang Yun-feng13,Kapur Anil14

Affiliation:

1. Peking University First Hospital, Beijing, China

2. First Affiliated Hospital of Sun Yat-sen University, Guangdong, China

3. First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Shanxi, China

4. Aviation General Hospital, Beijing, China

5. Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China

6. Maternal and Child Health Hospital of Taiyuan, Shanxi, China

7. West China Second University Hospital, Sichuan, China

8. First Affiliated Hospital of Chongqing Medical University, Chongqing, China

9. Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong, China

10. Guangdong Women and Children Hospital, Guangdong, China

11. Boai Hospital of Zhongshan, Guangdong, China

12. ShenZhen People’s Hospital, Guangdong, China

13. Miyunxian Hospital, Beijing, China

14. World Diabetes Foundation, Gentofte, Denmark

Abstract

OBJECTIVE To evaluate the value of fasting plasma glucose (FPG) value in the first prenatal visit to diagnose gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS Medical records of 17,186 pregnant women attending prenatal clinics in 13 hospitals in China, including the Peking University First Hospital (PUFH), were examined. Patients with pre-GDM were excluded; data for FPG at the first prenatal visit and one-step GDM screening with 75-g oral glucose tolerance test (OGTT) performed between 24 and 28 weeks of gestation were collected and analyzed. RESULTS The median ± SD FPG value was 4.58 ± 0.437. FPG decreased with increasing gestational age. FPG level at the first prenatal visit was strongly correlated with GDM diagnosed at 24–28 gestational weeks (χ2 = 959.3, P < 0.001). The incidences of GDM were 37.0, 52.7, and 66.2%, respectively, for women with FPG at the first prenatal visit between 5.10 and 5.59, 5.60 and 6.09, and 6.10–6.99 mmol/L. The data of PUFH were not statistically different from other hospitals. CONCLUSIONS Pregnant women (6.10 ≤ FPG < 7.00 mmol/L) should be considered and treated as GDM to improve outcomes; for women with FPG between 5.10 and 6.09 mmol/L, nutrition and exercise advice should be provided. An OGTT should be performed at 24–28 weeks to confirm or rule out GDM. Based on our data, we cannot support an FPG value ≥5.10 mmol/L at the first prenatal visit as the criterion for diagnosis of GDM.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference17 articles.

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4. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis;Bellamy;Lancet,2009

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