Evaluation of the Value of Fasting Plasma Glucose in the First Prenatal Visit to Diagnose Gestational Diabetes Mellitus in China
| Autor: | Mei-hua Zhang, Yun-hui Wang, Jian-min Niu, Hua Zhang, Zilian Wang, Anil Kapur, Nan Li, Yumei Wei, Yu-jie Gan, Huixia Yang, Jie Yan, Li-ruo Zhong, Hai-rong Wu, Xuelan Li, Weiwei Zhu, Xinghui Liu, Yun-Feng Wang |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Blood Glucose
medicine.medical_specialty China endocrine system diseases Endocrinology Diabetes and Metabolism Gestational Age Prenatal care Prenatal visit Pregnancy Diabetes mellitus Internal Medicine medicine Humans Epidemiology/Health Services Research Original Research Advanced and Specialized Nursing business.industry Obstetrics Medical record Gestational age nutritional and metabolic diseases Prenatal Care Fasting medicine.disease Gestational diabetes Diabetes Gestational Gestation Female business |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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