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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med Chin    2010, Vol. 4 Issue (3) : 303-307     DOI: 10.1007/s11684-010-0090-x
RESEARCH ARTICLE |
Difference between 2 h and 3 h 75 g glucose tolerance test in the diagnosis of gestational diabetes mellitus (GDM): Results from a national survey on prevalence of GDM
Xue-Lian GAO1, Yu-Mei WEI1, Hui-Xia YANG1(), Xian-Ming XU2, Ling FAN3, Jing HE4, Ning LIU5, San-Cun ZHAO6, Ya-Li HU7, Zi YANG8, Yun-Ping ZHANG9, Xing-Hui LIU10, Xu CHEN11, Jian-Ping ZHANG12, Wen-Li GOU13, Mei XIAO14, Hai-Rong WU15, Mei-Hua ZHANG16
1. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China; 2. Department of Obstetrics and Gynecology, First Affiliated People’s Hospital, Shanghai Jiao Tong University, Shanghai 200080, China; 3. Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China; 4. Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China; 5. Maternal and Child Health Care Hospital of Urumchi, Urumchi 830000, China; 6. Maternal and Child Health Care Hospital of Shanxi, Xi’an 710003, China; 7. Department of Obstetrics and Gynecology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China; 8. Peking University Third Hospital, Beijing 100191, China; 9. Maternal and Child Health Care Hospital of Haidian District, Beijing 100080, China; 10. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China; 11. Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300052, China; 12. Department of Obstetrics and Gynecology, the Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510120, China; 13. Department of Obstetrics and Gynecology, the First Affiliated Hospital, Medical School of Xi’an Jiaotong University, Shanxi 710061, China; 14. Department of Obstetrics and Gynecology, Hubei Maternal & Child Health Hospital, Wuhan 430100, China; 15. The Central Hospital of Aviation Industry of China, Beijing 100012, China; 16. Taiyuan Maternal and Infant Health Care Hospital of Shanxi Province, Taiyuan 030012, China
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Abstract  

The possibility of the 2 h oral glucose tolerance test (OGTT) as an alternative to the 3 h OGTT was investigated based on data from a national survey on pregnancy-associated diabetes. Data were retrieved from 4179 pregnant women who had OGTT performed after an abnormal 50 g glucose challenge test (GCT). All of the 4 glucose levels during their OGTT were collected and analyzed. According to American Diabetes Association (ADA) gestational diabetes mellitus (GDM) diagnostic criteria, among the 4179 pregnant women who required OGTT, 3429 (82.1%) were normal and 750 (17.9%) were diagnosed as GDM. If the 3rd h glucose levels were omitted from OGTT, 79 cases of GDM (10.5%) would be overlooked. No trend was shown where women with more risk factors were more likely to be overlooked if the 3rd h test was omitted (χ2 for trend= 0.038, P>0.05). No significant differences were found in the rate of cesarean section (CS), preterm births or macrosomia between the 79 cases and those with normal OGTT results and in the gestational weeks when OGTT was performed. It shows that in order to diagnose one woman with GDM, another 52 pregnant women would have an innocent 3rd h glucose test. Omission of the 3rd h glucose test in OGTT might be reasonable due to its convenience, better compliance and a small number of possibly miss-diagnosed cases, and their pregnancy outcomes have no significant difference from those of normal pregnant women.

Keywords diabetes      gestational      oral glucose tolerance test     
Corresponding Authors: YANG Hui-Xia,Email:yanghuixia@bjmu.edu.cn   
Issue Date: 05 September 2010
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-010-0090-x     OR     http://academic.hep.com.cn/fmd/EN/Y2010/V4/I3/303
basic informationall OGTT performednormal OGTTpossibly miss-diagnosed cases
mean age/yr*31.0±4.2 (n = 4179)29.8±3.8 (n = 2597)31.0±4.1 (n = 79)
prepregnant BMI*22.0±6.7 (n = 4179)21.1±2.8 (n = 2597)21.3±2.8 (n = 79)
delivery weeks/wk*39.1±1.6 (n = 2857)39.2±1.6 (n = 1733)39.0±1.4 (n = 56)
birth weight/g*3412.0±584.2 (n = 2857)3415.0±957.6 (n = 1733)3233.5±496.1 (n = 56)
Tab.1  Basic information of women who had OGTT performed
total numberno risk factor1 risk factor2 risk factors3 risk factors≥4 risk factors
n (%)n (%)n (%)n (%)n (%)
miss-diagnosed cases7919 (24.1)28 (35.4)23 (29.1)8 (10.1)1 (1.3)
all who had OGTT41791051 (25.1)1612 (38.6)993 (23.8)377 (9.0)146 (3.5)
χ20.050.321.220.12
P>0.05>0.05>0.05>0.05>0.05
Tab.2  Risk factors analysis of the possibly miss-diagnosed cases
glucose level /mmol·L-1fasting1st h (≥10.0 mmol/L)2nd h (≥8.6 mmol/L)miss-diagnosed cases (3rd h value≥7.8 mmol/L)
n (%)n (%)n (%)n (%)
13 (≥13,<14.0)1 (2.17)
12–1 (2.17)
11–9 (39.1)2 (4.35)2 (2.5)
10–14 (60.9)3 (6.52)3 (3.8)
9–26 (56.52)14 (17.7)
8–13 (28.26)40 (50.6)
7–20 (25.3)
6–1 (10.0)
5.3–9 (90.0)
total number10 (100.0)23 (100.0)46 (100.0)79 (100.0)
Tab.3  Distribution of the abnormal glucose values in OGTT in 79 miss-diagnosed cases
possibly miss-diagnosed cases (n=56)*normal OGTT cases (n=1733)*χ2P value
number%number%
cesarean section1628.668839.72.81>0.05
preterm birth47.118510.70.72>0.05
macrosomia 47.11136.50.03>0.05
Tab.4  Comparison of pregnancy outcomes between those possibly miss-diagnosed cases and women with normal OGTT
total number≥28 weeks24–28 weeks<24 weeks
n (%)n (%)n (%)
misdiagnosed cases7953 (67.1)24 (30.4)2 (2.5)
all who had OGTT41792614 (62.6)1280 (30.6)285 (6.8)
χ20.680.02.27
P value>0.05>0.05>0.05
Tab.5  The gestational weeks when OGTT was performed
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