Glycemic level at the first visit and prediction of GDM.

ABSTRACT

OBJECTIVE: To evaluate the glycemic level at the first visit that is likely to predict gestational diabetes mellitus (GDM). METHODS: Consecutive pregnant women underwent a 75g oral glucose tolerance Test (OGTT) recommended by WHO and diagnosed GDM if 2hr post plasma glucose (PG) value > or = 140 mg/dl. Women with normal OGTT results at the first visit were screened again with an OGTT at the subsequent visits. RESULTS: A total of 4151 pregnant women from different trimesters underwent OGTT. Of them 739 women (17.8%) had GDM. Among the GDM women, 528 (71.4%) were detected at the first visit. On screening during subsequent visits, GDM was diagnosed in the remaining 211(28.6%) women who had normal OGTT in the first visit. We performed the analysis taking the glycemic level in the first visit of 211 pregnant women who manifested GDM in the subsequent visit. During normal pregnancy, 2hr PG level is < 120 mg/dl. Taking this value into consideration among the 211 women who turned to have GDM in the subsequent visits 119 women (56.4%) had 2hrPG > or = 120 mg/dl and the remaining 92(43.6%) had 2hrPG < 120 mg/dl. CONCLUSION: Pregnant women irrespective of 2 hr PG > or = or < 120 mg/dl at initial visit progressed to GDM in the subsequent visit. No glycemic level in the early weeks of pregnancy predicts GDM and at the same time at no statistically significant glycemic cut-off level could we say that a woman will not develop GDM. Hence rescreening in the subsequent trimester or visits is essential.