Ha. Nasrat et al., THE DIAGNOSIS OF PATHOLOGICAL HYPERGLYCEMIA IN GESTATIONAL DIABETES IN A HIGH-RISK OBSTETRIC POPULATION, Diabetic medicine, 13(10), 1996, pp. 861-867
Citations number
23
Categorie Soggetti
Endocrynology & Metabolism","Medicine, General & Internal
In order to define a level of 'pathological hyperglycaemia', i.e. gluc
ose intolerance that predicts perinatal morbidity among the obstetric
population, 100 g glucose tolerance tests (GTTs) were performed in 660
patients attending for antenatal care at the University Hospital in J
eddah. The results were analysed in two ways: (1)patients were stratif
ied according to the number of abnormal glucose values on the GTTs and
(2) patients were placed into one of three groups according to the 10
0 g GTT diagnostic criteria, i.e. normal (non-GDM), abnormal with fast
ing blood glucose (FBG) greater than or equal to 5.8 mmol l(-1) (GDM),
and abnormal with FBC <5.8 mmol l(-1) (gestational induced hyperglyca
emia, GIH). Although there was a stepwise association between fetal/ma
ternal morbidity with increasing number of abnormal glucose values, no
level of glucose intolerance could be defined as a threshold level fo
r normal response. However, when stratified by FBG, GDM patients were
significantly heavier (78.5 kg +/- SD 14.9), had a higher incidence of
both macrosomia (27.5%) and operative delivery (25.3 %) than the othe
r two groups (14.7%, 14.3%, and 15.4%, 12.8% in the non-GDM and GIH, r
espectively). It is suggested that among patients with abnormal GTT re
sults a FBG greater than or equal to 5.8 mmol l(-1) identifies a thres
hold for true 'pathological hyperglycaemia'.