Can We Rely Solely on Fasting Parameters Instead of Oral Glucose Tolerance Test for Gestational Diabetes Mellitus Screening?

Authors : Sema Baki Yıldırım, Neslihan Bezirganoglu Altuntas
Pages : 373-379
Doi:10.38136/jgon.1705170
View : 34 | Download : 49
Publication Date : 2025-09-30
Article Type : Research Paper
Abstract :Objective: Gestational diabetes mellitus (GDM) poses significant risks during pregnancy. While the oral glucose tolerance test (OGTT) remains the diagnostic standard, its complex-ity and poor patient compliance highlight the need for simpler alternatives. This study evaluates whether fasting glucose and other metabolic parameters can effectively replace the OGTT for GDM screening in Turkish pregnant women, offering a more practical and efficient diagnostic approach tailored to this population. Methods: This retrospective ob-servational study was conducted between January 2020 and August 2022 in two materni-ty hospitals in the same region. It was conducted with 192 women diagnosed with GDM and 384 healthy pregnant women matched by maternal age in a 1:2 ratio. An receiver operating characteristic (ROC) analysis was performed to determine the association be-tween the biochemical blood parameters tested in the second trimester and the diagnosis of GDM. Results: The study included 576 pregnant women. The GDM group showed a higher pre-pregnancy BMI compared with the healthy controls (p < 0.01). There were sta-tistical differences in the fasting plasma glucose (FPG), fasting insulin, and HbA1c be-tween the groups (p = 0.001, 0.001, and 0.01, respectively). In the ROC analysis, the FPG had the highest AUC value (0.920). Conclusions: Among the pregnant women with GDM, 66.6% had an FPG ≥ 92, 54% had fasting insulin ≥ 15.7 microU/mL, and 12.7% had hemo-globin A1c (HbA1c) ≥ 5.7. The FPG had the highest diagnostic accuracy. Pregnant women in Turkey who do not undergo the OGTT for GDM screening should be counseled about the necessity of the OGTT to avoid missing a GDM diagnosis.
Keywords : gestasyonel diyabet, glukoz tolerans testi, açlık kan şekeri, gebelik, tanısal tarama

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