Entrar/Registro  
HOME SPANISH
 
Ginecología y Obstetricia de México
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Ginecología y Obstetricia de México >Year 2018, Issue 04


Font-López KC, Marcial-Santiago AR, Becerril-Cabrera JI
Validity of blood glucose fasting test as diagnostic for gestational diabetes during the first trimester of pregnancy
Ginecol Obstet Mex 2018; 86 (04)

Language: Español
References: 20
Page: 233-238
PDF: 223.37 Kb.


Full text




ABSTRACT

Objectives: To determine the validity of fasting blood glucose as the only value to perform the diagnosis of gestational diabetes in the first trimester of pregnancy, according to the criteria of the IADPSG. To calculate the sensitivity, specificity, positive and negative predictive value of this test comparing it with the gold standard “Oral glucose tolerance test”.
Materials and Methods: Case-control retrospective study carried out from 2014 to 2017. In the case group, patients diagnosed with gestational diabetes were included in the week 24 to 28 of pregnancy through an oral glucose tolerance test. Fasting blood glucose was recorded in the first trimester of pregnancy. A random sampling was done to obtain the control group with the result of the negative test. Statistical analysis was performed with SPSS Statistics. For the validity of the test, sensitivity, specificity, PPV, NPV, positive and negative likelihood ratio were calculated.
Results: In the case group, 204 patients were obtained, 68.1% with fasting blood glucose ≥ 92 mg/dL and 31.9% with normal glucose values in the first trimester of pregnancy. 50% of overweight patients and 100% of patients with obesity had glycemia ≥ 92 mg/dL. In the control group of 204 patients, only 5.3% had values ≥ 92 mg/dL. The OR for the development of gestational diabetes with this glucose value in the first trimester was 37.5 95%CI: 19.1-73.7. The sensitivity of the test was 68%, specificity 95%.
Conclusion: The fasting glucose value as the only diagnostic test of gestational diabetes during the first trimester has an acceptable sensitivity and a good specificity especially in patients with overweight or obesity.


Key words: Fasting blood glucose, Gestational diabetes, First trimester, Oral glucose tolerance, Overweight, Obesity.


REFERENCIAS

  1. Voto L, Nicolotti A, Salcedo L, González M, Nasiff J, Cremonte A. et al. Consenso de Diabetes. Conclusiones del consenso. Recopilación, actualización y recomendaciones para el diagnóstico y tratamiento de la diabetes gestacional. Rev Soc Arg Diab. 2012;11:37-48.

  2. Committee on Practice Bulletins Obstetrics. Gestational diabetes mellitus. Practice Bulletin No. 137. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013;122:406-16.

  3. Font-López KC, Gutiérrez-Castañeda MR. Diagnóstico de diabetes gestacional en población mexicana. Ginecol Obstet Mex. 2017 feb;85(2):116-124.

  4. Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care.2002; 25:1862-1868.

  5. Tang JW, Foster KE, Pumarino J, Ronald T. et al. Perspectives on Prevention of Type 2 Diabetes After Gestational Diabetes: A Qualitative Study of Hispanic, African- American and White Women. Matern Child Health J. 2015;19:1526-1534.

  6. American Diabetes Association (ADA). Diabetes Management Guidelines. http://www.ndei.org/ADA-diabetesmanagement- guidelines-diagnosis-A1C-testing.aspx

  7. www.cenetec-difusion.com/CMGPC/IMSS-320-10/ER.pdf

  8. World Healt Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. 2013. [en línea] Dirección http://www.who.int/diabetes/ publications/Hyperglycaemia_In_Pregnancy/en/

  9. The HAPO Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcomes. N Engl Med. 2008;358:1991-2002.

  10. National Institute for Health and Excellence. NICE guideline. Diabetes in pregnancy: management from preconception to the postnatal period. [en línea] Dirección URL: https://www. nice.org.uk/guidance/ng3?unlid=784191402016231162. (Consulta: agosto 2015)

  11. Riskin MS, Younes G, Damti A, Auslender R. First trimester fasting hyperglycemia and adverse pregnancy outcomes. Diabetes Care. 2009; 32:1639-43.

  12. McDonald R, Karahalios A, Thao L, Joanne S. A retrospective analysis of the relationship between ethnicity and gestational diabetes. Int J Endocrinol. 2015;2015:1-7.

  13. Meek CL, Lewis JB, Patient C, Murphy HR, et. al. Diagnosis for gestational diabetes mellitus: falling through the net. Diabetologia. 2015;58:2003-2012.

  14. Ríos MW, García SA, Ruano HL y col. Complicaciones obstétricas de la diabetes gestacional: criterios de la IADPSG y HAPO. Perinatol Reprod Hum. 2014,28:27-32.

  15. Calculadores médicos. Dirección URL: https://www. samiuc.es/index.php/estadisticas-con-variables-binarias/ indicadores-en-pruebas-diagnosticas/calculador-deindicadores- en-pruebas-diagnosticas.html.

  16. American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes 2018. Diabetes Care 2018;41:S13-S27. https://doi.org/10.2337/dc18-S002

  17. Bartha JL, Martínez P, Comino R. Gestational diabetes mellitus diagnosed during early pregnancy. Am J Obstet Gynecol 2000;182:346-50

  18. Syngelaki A, Pastides A, Kotecha R. et. Al. First-Trimester Screening for Gestational Diabetes Mellitus Based on Maternal Characteristics and History. Fetal Diagn Ther 2015;38:14-21.

  19. Feig DS, Donovan LE, Corcoy R, et al. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet 2017; 390: 2347-2359.

  20. Secretaría de Salud. Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 (ENSANUT MC 2016). Dirección URL: http://fmdiabetes.org/wp-content/ uploads/2017/04/ENSANUT2016-mc.pdf






>Journals >Ginecología y Obstetricia de México >Year 2018, Issue 04
 

· Journal Index 
· Links 






       
Copyright 2019