Is the 50-gram glucose screening test ever diagnostic?

The Journal of Maternal-fetal Medicine
R A BobrowskiM P Dombrowski

Abstract

The standard criteria for the diagnosis of gestational diabetes (GDM) is based on two abnormal values of a 3-h-100-g oral glucose tolerance test (GTT). Although a markedly elevated 1 h-50-g screen value has been suggested to support a diagnosis of GDM, limited data are available to substantiate this empiric observation. Our purpose was to examine the utility of various 50-g screen cutoff values in establishing the diagnosis of gestational diabetes. We identified 422 gravidas with a positive 50-g screen (> or = 135 mg/dl) who underwent additional glucose testing. GDM was defined according to the National Diabetes Data Group (NDDG) standards for the 3-h GTT. An analysis employing the criteria of Carpenter and Coustan was performed for comparison. If a patient had an elevated 50-g value and no 3-h GTT was performed, a fasting serum glucose > or = 140 mg/ dl was considered evidence of gestational diabetes. One hundred twenty four (29.4%) had GDM as defined by the NDDG criteria; this increased to 161 (38%) when the diagnosis was based on Carpenter and Coustan's criteria. The mean (+/- SD) gestational age at screening was 24 +/- 7 weeks. As expected, the prevalence of GDM increased in relation to an increasing 50-g value. All subject...Continue Reading

Citations

May 16, 2014·Canadian Journal of Diabetes·David ThompsonChristina Vinokuroff
Jun 3, 2004·Obstetrics and Gynecology·Yariv YogevBarak Rosenn
May 2, 2006·American Journal of Obstetrics and Gynecology·Sarah FriedmanOvadia Abulafia
Jan 23, 2016·Journal of Perinatology : Official Journal of the California Perinatal Association·L A TemmingA G Cahill
May 30, 2009·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Aydan BiriOzdemir Himmetoglu
Jul 29, 2004·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Susan Lanni, Diane Barrett

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