The Comparison of the 50 gr Oral Glucose Tolerrance Test Results with the Body Mass Index in the Pregnancy Period of Women

Yıl 2017, Cilt: 12 Sayı: 1, 45 - 49, 16.05.2017

Uğurkan Erkayıran , Selim Koncagül Zahide Küçük

https://doi.org/10.17517/ksutfd.302623

Cited By: 1

Öz

Objectives:
The direct corellation between body mass index and gestational diabetes
mellitus has been shown in recent studies. 
In  this study, our aim is to
compare  our cases’  body mass index with the results of 50 grams
OGTT  who have 24-28 weeks gestation and
to evaluate the OGTT results of the groups which are categorized as weak,
normal weight, overweight, obese and morbidly obese according to body mass
index.

 

Materials and
Methods: There were included 200 patients who referred to our hospital as
having a 24-28 weeks gestation. Our patients’ height and weight measuements
were performed. By calculating body mass index, they were grouped as weak,
normal weight, overweight, obese and morbidly obese 50 grams of glucose were
applied orally at any time of the day without considering patient’s hunger.Body
mass index and OGTT results were examined by comparing.

 

Results:
In the group of patients who had lower body mass index value than 25 kg/m²
, it was seen that the rate of patients who have  lower OGTT value than 140 mg/dl was
statistically much more than others. Between the group of patients who have
lower OGTT value than 140 mg/dl and the group of patients who have 140 mg/dl
and higher, the rate of patients who have body mass index value between 25 and
25.9 was found statistically similar. 
Considering the group which had lower OGTT value than 140 mg/dl, the
rate of patients who have 30 kg/ m² and higher body mass index level
was statistically higher in the group which has 140 mg/dl and higher.     

 

Conclusion: Obesity
is a serious risk factor for gestational diabetes mellitus. Pregnant women who
have 30 kg/ m²   and higher body
mass index value should be tested for diabets at the first antepartum visit and
if there is not encountered any pathological situation 50 grams OGTT should be repeated
in 24-28 weeks gestation. 

Anahtar Kelimeler

body mass index, oral glucose tolerance test 50 gr, gestational dibetes mellitus

Gebelerde 50 gr Oral Glukoz Tolerans Test Sonuçları ile Vücut Kitle İndeksinin Karşılaştırılması

Öz

Amaç:
Vücut kitle
indeksi ile Gestasyonel Diabetes
Mellitus arasında doğrudan ilişki olduğu yapılan çalışmalarda gösterilmiştir.
Bizim bu çalışmamızda amacımız 24-28 hafta gebeliği olan olgularımızın vücut
kitle indeksleri ile 50 gram OGTT sonuçlarını karşılaştırmak ve vücut kitle
indeksine göre zayıf, normal kilolu, fazla kilolu, obez ve morbid obez olarak
sınıflandırdığımız gruplar arasındaki OGTT sonuçlarını değerlendirmektir.

 

Gereç ve Yöntem: Bu çalışmaya 24-28 hafta gebeliği olan 200 hasta alındı.
Hastalarımızın boy ve kilo ölçümleri yapıldı. Vücut Kitle İndeksleri
hesaplanarak zayıf, normal, fazla kilolu,  obez ve morbid obez olarak gruplara ayrıldı. 50
gram glukoz oral
yoldan günün herhangi bir saatinde hastanın açlığı gözetilmeden uygulandı. vücut kitle indeksi
ile 50 gram OGTT sonuçları karşılaştırıldı.

 

Bulgular: OGTT sonrası glukoz değeri 140
mg/dl ve üzerinde olan grupta,  glukoz
değeri 140 mg/dl’den düşük olan gruba göre, vücut kitle indeksi düzeyinin 30 kg/m² ve daha yüksek olanların
oranı istatistiksel olarak daha yüksek bulundu(p=0,048). Vücut kitle indeksi
düzeyinin 25 kg/m^2' den düşük olanların oranı,  50 gr OGTT sonucunda glukoz değeri 140 mg/dl’den düşük olan
grupta, OGTT deki glukoz değeri 140 mg/dl ve üzerinde olan gruba göre
istatistiksel olarak daha yüksek bulundu(p=0,015). OGTT değeri 140 mg/dl’den
düşük olan grup ile  OGTT değeri 140
mg/dl ve üzerinde olan grup arasında, vücut kitle indeksi 25-29,9 arasında olanların oranı
istatistiksel olarak benzer bulundu (p=0,581).

 

Sonuç: Obezite, GDM için ciddi bir risk faktörüdür. Vücut kitle indeksi 30 kg/m² ve üstünde olan gebeler ilk
antepartum vizitte diabet açısından taranmalı eğer herhangi patolojik bir
duruma rastlanılmazsa, 50 gram OGTT 24-28. gebelik haftalarında
tekrarlanılmalıdır. Bu hastaların antenatal kontrolleri daha sık yapılmalı ve
mümkünse endokrinolog, diyetisyen ve kadın doğum uzmanından oluşan sabit bir
ekipçe sürdürülmelidir.

Anahtar Kelimeler

Vücut kitle indeksi, OGTT 50 gr, Gestasyonel Diabetes Mellitus

Kaynakça

• 1. Nedim Çiçek M, Akyurek C, Çelik C, Haberal A. Diabetes mellitus ve gebelik. Kadın Hastalıkları ve Dogum Bilgisi 2006: 435-450.
• 2. Carpenter MW, Coustan DR. Criteria for scree-ning tests for gestational diabetes mellitus. Am Obstet Gynecol 1982;144(7):768.
• 3. Turok DK, Ratcliffe SD, Baxley AG.Management of gestational diabetes mellittus. Am Fam Physician 2003;68(9):1769-1772.
• 4. Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, Wapner RJ, Varner MW, Rouse DJ, Thorp JM Jr, Sciscione A, Catalano P, Harper M, Saade G, Lain KY, Sorokin Y, Peaceman AM, To-losa JE, Anderson GB, Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 2009; 361:1339 –1348
• 5. Özçimen EE, Uçkuyu A, Çiftçi FC, Yanık FF, Bakar C. Diagnosis of gestational diabetes mellitus by use of the homeostasis model assessment insulin resistance index in the first trimester.GynecolEndocrinol2008:24(4):224-249. http://dx.doi.org/10.1080/09513590801948416 PMid:18382910
• 6. Marquette GP, Klein VR, Niebyl JR. Efficacy of screening for gestational diabetes. Am J Perinatol 1985:2(1):7-9. http://dx.doi.org/10.1055/s-2007-999901 PMid:3921038
• 7. O\’Sullivan JB, Mahan CM, Charles D, Dandrow RV. Screening criteria for high risk gestational diabetic patients. Am J Obstet Gynecol 1973;116(9):895-900. PMid:4718216
• 8. Hills S. DIAMAP – mapping the future of diabetes research. Diabetes Voice. 2009;54(3):45–8.
• 9. Halban PA. Prime time for DIAMAP: A road map for diabetes research in Europe. Diabetologia. 2010;53(9):1835–7. doi: 10.1007/s00125-010-1774-0.
• 10. Kuhl C. Glucose metabolism during and after pregnancy in normal and gestational diabetic woman. Acta Endocrinol 1995;79(4):709-719
• 11. ACOG Technical bulletin: Diabetes and pregnancy. Number 200, December 1994. Int J Gynecol Obstet 1995,48:331-339.
• 12. Abenhaim HA, Kinch RA, Morin L, Benjamin A, Usher R. Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes. Arch Gynecol Obstet 2007; 275(1): 39-43
• 13.World Health Organization W. Obesity and overweight. http://www.who.int/mediacentre/factsheets/ fs311/en/: 2016 June 2016
• 14. American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care; 28(Suppliment 1): January 2005
• 15. Couston D. Maternal age and screening for ges-tational diabetes: A population based study. Obstet Gynecol 1989;73(4):557-561.
• 16. American College of Obstetricians and Gynecologists: Diabetes and pregnancy. ACOG Technical Bulletin. Washington, DC 1994.
• 17. Stodhard KJ, Tennent PWG, Bell R, Rankin J. Maternal overweight and obesity and risk of congenital anomalies. A systemic rewiev and meta- analysis. JAMA. 2009;301(6):636-50.
• 18. Drake AJ, Reynolds RM. Impact of maternal obesity on offspiring obesity and cardiometabolic disease risk. Reproduction. 2010:140(3);387-398.
• 19. Guelinckx I, Devlieger R, Beckers K. and Vansant G, Complications of Obesity
• 20. Daşıkan Z, Kavak O. Maternal obesity: Pregnancy complications an managemant of pregnant woman: Review [Maternal obezite: gebelik komplikasyonları ve gebe kadın yöntemi]. Türkiye Klinikleri J NUrs Sci. 2009;1(1):39-46
• 21. Yee, L. M., Cheng, Y. W., Inturrisi, M. & Caughey, A. B. Effect of gestational weight gain on perinatal outcomes in women with type 2 diabetes mellitus using the 2009 Institute of Medicine guidelines. American journal of obstetrics and gynecology 205, 257.e251–256, doi:10.1016/j.ajog.2011.06.028 (2011).
• 22. Metzger, B. E. et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes care 33, 676–682, doi:10.2337/dc09-1848 (2010).
• 23. Dodd, J. M., Grivell, R. M., Nguyen, A. M., Chan, A. & Robinson, J. S. Maternal and perinatal health outcomes by body mass index category. The Australian & New Zealand journal of obstetrics & gynaecology 51, 136–140, doi:10.1111/j.1479-828X.2010.01272.x (2011).
• 24. Owens, L. A. et al. ATLANTIC DIP: the impact of obesity on pregnancy outcome in glucose-tolerant women. Diabetes care 33, 577–579, doi:10.2337/dc09-0911 (2010).
• 25. Catalano, P. M. et al. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes care 35, 780–786, doi:10.2337/dc11-1790 (2012).
• 26. Dennedy, M. C. et al. ATLANTIC-DIP: raised maternal body mass index (BMI) adversely affects maternal and fetal outcomes in glucose-tolerant women according to International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. The Journal of clinical endocrinology and metabolism 97, E608–E612, doi:10.1210/jc.2011-2674 (2012).
• 27. Nohr, E. A. et al. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. The American journal of clinical nutrition 87, 1750–1759 (2008).
• 28. Black, M. H., Sacks, D. A., Xiang, A. H. & Lawrence, J. M. The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes care 36, 56–62, doi:10.2337/ dc12-0741 (2013).