Evaluation of first trimester fasting blood glucose as a predictor of gestational diabetes mellitus
Journal Title: Indian Journal of Obstetrics and Gynecology Research - Year 2017, Vol 4, Issue 1
Abstract
Background: Our goal was to find association between first trimester fasting blood sugar value compared with the second trimester oral glucose tolerance test value (75gm DIPSI criteria) for diagnosis of GDM. To find the efficiency of FBS and BMI as a screening test for GDM. Material and Method: 270 antenatal patients having antenatal follow up from 1st trimester of pregnancy between June 2014 – May 2015. The study period was 12 months. Their fasting blood glucose levels was measured in first trimester. The patients were followed up during second trimester and 75 grams OGTT was done. Correlation between first trimester FBS, BMI versus second trimester OGTT were done. Screening property of both fasting blood sugar and BMI were calculated and compared using receiver operating characteristic (ROC) curves. Result: Out of 270 patients, 14 patients developed GDM, 1 patient developed overt diabetes. With threshold of FBS>90 yielded sensitivity of 86%, specificity of 52%. FBS >90mg/dl can be considered as a threshold value for predicting GDM. With a threshold of BMI>24 yielded sensitivity of 60%, specificity of 67.5%, hence BMI >24 is a good predictor of GDM. Receiver operating characteristic curve shows FBS(AUC-0.69) has little more discriminatory power in identifying GDM than BMI(AUC=0.63). P value <0.05 was considered statistically significant. Conclusion: In conclusion, FBS measurement at first prenatal visit or at first booking will be useful to screen for previously undiagnosed pre-existing diabetes mellites and also help to predict the development of GDM earlier.
Authors and Affiliations
Reshma Shri Aravind, Latha Maheshwari, Aravind Chander
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