The effıciency of the first trimester 50 grams glucose tolerance test for detection of the gestational diabetes and the outcome of the pregnancy

Abstract

We aimed to evaluate the effectiveness of the first trimester's 50 g glucose loading as a screening test for gestational diabetes mellitus and to find a cut-off value for 50 g OGCT in the first trimester. This study was conducted on pregnant women at low risk for diabetes mellitus. A 50-g glucose load was done in the first trimester, and then pregnant women were followed up. A 100-gram diagnostic test for gestational diabetes mellitus was administered to all participants at 24–28 weeks of gestation. The sensitivity, specificity, and false-positive rate of the 50 g glucose challenge test were determined. A total of 454 pregnant women were assessed in this study. 34 women (7.5%) were diagnosed with gestational diabetes. 420 women have constituted the non-diabetic group. In patients with gestational diabetes, age, weight, polyhydramnios, and macrosomia rates were significantly higher than in the non-diabetic group. The discriminative power of the 50 g glucose test in the first trimester was found to be significant (p = 0.001) in gestational diabetic patients. The area under the ROC curve was 0.927. The best cut-off value was 143 mg/dl. In this value, the sensitivity and false-positive rate were 85% and 11%, respectively. A 50-g glucose challenge test done in the first trimester may contribute to the reduction of maternal and perinatal risks and prevent long-term consequences such as obesity, type 2 diabetes mellitus, and lipid profile disorders with early glycemic control and lifestyle changes.

Keywords

• Diabetic complications
• First trimester pregnancy
• Gestational diabetes mellitus
• 50 g glucose loading test

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