A Comparative Study of Gestational Diabetes Mellitus at 24–28 Weeks Between Women With Normal and One Abnormal Value of 100-Gram Oral Glucose Tolerance Test Before 24 Weeks
Keywords:
gestational diabetes mellitus, single abnormal value, 100-gram oral glucose tolerance testAbstract
Objective: The aim of our study is to compare the incidence of gestational diabetes mellitus (GDM) at 24–28 weeks of gestation between women with normal results and those with one abnormal value on the 100-g oral glucose tolerance test (OGTT) performed before 24 weeks.
Methods This prospective cohort study enrolled pregnant women at Amnatcharoen Hospital (January 2022–December 2024). Participants who underwent an initial 100-g oral glucose tolerance test (OGTT) before 24 weeks of gestation were categorized into two groups: normal results or a single abnormal value (SAV). A repeat OGTT was performed at 24–28 weeks to diagnose gestational diabetes mellitus (GDM). Chi-square test and logistic regression were used to analyze associations and adjust for confounding factors.
Results: The incidence of GDM was significantly higher in the SAV group, which was 66.7% (40 out of 60), compared to the normal group, which was 9.5% (43 out of 452) (p < .001). After adjusting for confounders (pre-pregnancy obesity, history of macrosomic infants 4,000 g, and first-degree family history of diabetes), the single abnormal value (SAV) was the strongest independent predictor for GDM (adjusted OR 17.3; 95% CI 9.1–32.7). Furthermore, GDM patients from the SAV group required insulin/medication (GDMA2) significantly more often (30.0% vs. 7.0%; p < .001).
Conclusion: A single abnormal value on the 100-g OGTT before 24 weeks is a strong predictor for GDM. Women with SAV represent a distinct high-risk population, differing from normal controls. Close surveillance and repeat diagnostic testing are essential in this group for timely diagnosis and management.
References
U.S. Preventive Services Task Force. Screening for gestational diabetes mellitus: recommendation statement. Am Fam Physician. 2014;90(11):790–4.
กรมอนามัย กระทรวงสาธารณสุข. แนวเวชปฏิบัติการดูแลหญิงตั้งครรภ์ที่มีภาวะเบาหวานขณะตั้งครรภ์. กรุงเทพมหานคร: กรมอนามัย; 2564.
สมาคมโรคเบาหวานแห่งประเทศไทย. แนวทางเวชปฏิบัติสำหรับโรคเบาหวาน 2566. กรุงเทพมหานคร: สมาคมโรคเบาหวาน; 2566.
Sirirat S, Boriboonhirunsarn D, Ruangvutilert P, Yapan P. Prevalence of gestational diabetes mellitus among women with lower risk for gestational diabetes in Siriraj Hospital. Thai J Obstet Gynaecol. 2022;30(5):313–20.
ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 2. Classification and diagnosis of diabetes: Standards of care in diabetes-2023. Diabetes Care. 2023;46(suppl 1):S19–40. doi: 10.2337/dc23-S002.
International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82. doi: 10.2337/dc09-1848.
Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982;144(7):768–73. doi: 10.1016/0002-9378(82)90349-0.
Landon MB, Gabbe SG. Gestational diabetes mellitus. In: Gabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux ERM, et al, editors. Obstetrics: Normal and problem pregnancies. 7th ed. Philadelphia: Elsevier; 2016. 689–707.
Roeckner JT, Sanchez-Ramos L, Jijon-Knupp R, Kaunitz AM. Single abnormal value on 3-hour oral glucose tolerance test during pregnancy is associated with adverse maternal and neonatal outcomes: a systematic review and meta analysis. Am J Obstet Gynecol. 2016;215(3):287–97. doi: 10.1016/j.ajog.2016.04.040.
Kang S, Kim MH, Kim MY, Hong JS, Kwak SH, Choi SH, et al. Progression to gestational diabetes mellitus in pregnant women with one abnormal value in repeated oral glucose tolerance tests. Diabetes Metab J. 2019;43(5):607–14. doi: 10.4093/dmj.2018.0159.
Lee SU, Hong S, Choi SK, Kim SM, Shin JE, Kil KC, et al. Glucose tolerance test with a single abnormal value as a predictor of type 2 diabetes mellitus: a multicenter retrospective study. Sci Rep. 2024;14(1):6792. doi: 10.1038/s41598-024-57535-8.
Berezowsky A, Raban O, Aviram A, Zafrir-Danieli H, Krispin E, Hadar E. Glucose tolerance test with a single abnormal value in pregnancy and the risk of type-2 diabetes mellitus. Arch Gynecol Obstet. 2022;305(4):869–75. doi: 10.1007/s00404-021-06207-3.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
