The diagnosis of "pathological hyperglycaemia' in gestational diabetes in a high risk obstetric population.
In order to define a level of "pathological hyperglycaemia', i.e. glucose 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 Jeddah. The results were analysed in two ways: (1) patients were stratified according to the number of abnormal glucose values on the GTTs and (2) patients were placed into one of three groups according to the 100 g GTT diagnostic criteria, i.e. normal (non-GDM), abnormal with fasting blood glucose (FBG) > or = 5.8 mmol l-1 (GDM), and abnormal with FBG < 5.8 mmol l-1 (gestational induced hyperglycaemia, GIH). Although there was a stepwise association between fetal/maternal morbidity with increasing number of abnormal glucose values, no level of glucose intolerance could be defined as a threshold level for 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 other two groups (14.7%, 14.3%, and 15.4%, 12.8% in the non-GDM and GIH, respectively). It is suggested that among patients with abnormal GTT results a FBG > or = 5.8 mmol l-1 identifies a threshold for true "pathological hyperglycaemia'.
Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
H A
HA
Nasrat
M S
MS
Ardawi
B A
BA
Abalkhail
D000328:Adult; D000704:Analysis of Variance; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D002585:Cesarean Section / Q000706:statistics & numerical data*; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology*; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000503:physiopathology; D007231:Infant, Newborn; D009017:Morbidity; D011247:Pregnancy; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors
D001786:Blood Glucose