Fasting plasma glucose versus glucose challenge test: Screening for gestational diabetes and cost effectiveness

Université de Montréal, Montréal, Quebec, Canada
Clinical Biochemistry (Impact Factor: 2.28). 10/2004; 37(9):780-4. DOI: 10.1016/j.clinbiochem.2004.05.018
Source: PubMed


To compare the performance in screening for gestational carbohydrate intolerance of the 1-h 50-g glucose challenge test (GCT), fasting plasma glucose (FPG) and fasting capillary glucose (FCG).
FPG and FCG were measured at the same time as the GCT in 188 women. Gestational carbohydrate intolerance was diagnosed according to the Canadian Diabetes Association criteria. We constructed receiver operator characteristic (ROC) curves and compared the sensitivity and specificity of the FPG, FCG and GCT.
Gestational diabetes was diagnosed in 11.2% women and gestational impaired glucose tolerance in 8.4%. The areas under the ROC curves for the FPG, the GCT and the FCG were not statistically different (P = 0.26). The GCT yielded a better specificity than the FPG and the FCG for a comparable level of sensitivity.
The GCT is better than the FPG in our population and is cost effective.

1 Read
  • Source
    • "Because our study included mild glucose tolerance patients, it was possible that fasting glucose in insulin treatment group was similar to that in diet group. Moreover, it has been reported that fasting glucose has diverse results in different populations[19,20]. In our Japanese study,Data are means ± standard deviation or percentage as indicated. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study assessed indicators of the need for insulin therapy and the effect of treatment on pregnancy outcomes in Japanese patients with gestational diabetes mellitus (GDM). All patients diagnosed with GDM were hospitalized for three days. Plasma glucose profiles in patients under strict dietary management and the characteristics of GDM patients with high daily glucose levels were investigated. Patients who failed to achieve glycemic targets were treated with insulin. Indicators of the need for insulin treatment were investigated. Pregnancy outcomes in patients prescribed dietary management and patients prescribed insulin treatment were compared. The study included 112 patients with GDM. GDM patients with high daily glucose levels in the hospital exhibited significantly higher 1-h and 2-h plasma glucose levels in oral glucose tolerance tests (OGTTs) at diagnosis. In our hospital, 102 GDM patients with singleton pregnancies were followed until delivery; 32 (31.3%) were treated with insulin. Univariate analysis identified significant associations of insulin requirement with family history of diabetes and with 1-h and 2-h OGTT values at diagnosis. Multivariate analysis showed that the 1-h OGTT plasma glucose level at diagnosis was an independent predictor of the need for insulin. In perinatal outcomes, insulin treatment was associated with low birth weight.
    Full-text · Article · Nov 2015 · Endocrine Journal
  • [Show abstract] [Hide abstract]
    ABSTRACT: Traditionally, screening for gestational diabetes mellitus (GDM) has been done only for those women with identifiable risk factors. To determine the value of screening all pregnant women, 363 consecutive patients were tested for GDM using a glucose challenge test (GCT). The test measured plasma glucose 1 hour after administration of a 50-gram oral glucose load. Those patients with a plasma glucose greater than 140 mg/dL were given a standard 3-hour glucose tolerance test (GTT) using 100 g of oral glucose. Patients with risk factors were compared with those without risk factors. There was no significant difference between the two groups for number of abnormal 3-hour GTTs. We conclude that in order to identify GDM, all pregnant patients must be screened. Universal screening was found to be simple and cost effective.
    No preview · Article · Apr 1988 · The Journal of the American Board of Family Practice / American Board of Family Practice
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated whether homeostatic indices of insulin sensitivity might suitably screen for gestational diabetes mellitus. One hundred twenty-three pregnant women who were between 24 and 28 weeks of gestation completed a 3-hour 100-g oral glucose challenge test and fasting insulin level in a nested case-control study design. Insulin sensitivity indices were calculated and tested for their ability to detect gestational diabetes mellitus. Fasting glucose demonstrated the best overall accuracy, but the homeostasis model assessment and quick insulin sensitivity check index were also sensitive screening techniques for gestational diabetes mellitus when either the National Diabetes Data Group or Carpenter-Coustan criteria were used. Homeostasis model assessment, quick insulin sensitivity check index, and fasting glucose are sensitive screening tests for gestational diabetes mellitus and can avoid oral administration of glucose-containing solutions.
    No preview · Article · Jul 2006 · American journal of obstetrics and gynecology
Show more