Lack of Concordance between the 75-g and 100-g Glucose Load Tests for the Diagnosis of Gestational Diabetes Mellitus

Clinical Chemistry - Tập 52 Số 9 - Trang 1679-1684 - 2006
Giorgio Mello1, Elena Parretti1, Agostino Ognibene2, Riccardo Cioni1, Tondi Filippo1, Paola Pezzati2, Monica Pratesi3, Gianfranco Scarselli1, Gianni Messeri2
1Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Firenze, Italy.
2Department of Laboratory, Clinical Chemistry Laboratory, Azienda Ospedaliero–Universitaria Careggi, Firenze, Italy
3Department of Statistics and Mathematics Applied to Economics, University of Pisa, Pisa, Italy

Tóm tắt

Abstract Background: Gestational diabetes mellitus (GDM) is common and can have a substantial impact on fetal growth, birth weight, and morbidity. The American Diabetes Association recommends GDM testing with either a 3-h, 100-g glucose load (100g) (criteria according to Am J Obstet Gynecol 1982;144:768–73) or a 2-h, 75-g glucose load (75g). We investigated the comparability of the 75g and the 100g tests in the diagnosis of GDM. Methods: From January 1997 to December 1999, in 1061 consecutive Caucasian nonobese and nondiabetic pregnant women who attended the Maternal-Fetal Medicine Unit, we performed GDM testing with a 75-g load during 2 periods of pregnancy: early (16–20 weeks) and late (26–30 weeks). Because we assumed there would be few GBM cases in women with a 1-h plasma glucose <1300 mg/L in the 75g test, we did not retest these women. We retested the remaining women with possible or diagnosed GDM with a 100-g load within a week. Results: GDM was diagnosed in 41 of 227 women with the 100-g load and 15 of 227 with the 75-g load (11 concordant); the κ index was 0.21. At 26–31 weeks of pregnancy, 484 of 976 women (49.9%) underwent both tests. GDM was diagnosed in 60 of 484 woman with the 100-g load and in 26 of 484 with the 75-g load (13 concordant); the κ index was 0.18. Conclusions: Among women with possible GDM in both early and late periods of pregnancy, there was only weak diagnostic agreement between results determined with 75-g and 100-g glucose loads.

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Tài liệu tham khảo

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Clinical Chemistry

Tập 52 Số 9

1679-1684

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