[Usefulness of the third-hour plasma glucose measurement of the oral glucose tolerance test for the diagnosis of gestational diabetes mellitus].
OBJECTIVE
To value the utility of the third-hour plasma glucose measurement of the oral glucose tolerance test (OGTT) for diagnosis of gestational diabetes mellitus (GDM). To analyse the relation of rate insulin therapy, type of delivery and morbidity and mortality perinatal with the third-hour plasma glucose measurement or not for diagnosis of GDM.


METHODS
Historic cohort study.


METHODS
Women diagnosed of GDM from 1993 to March of 2002 in Pregnancy Consultation in periurban Primary Care Center in Camas (Seville, Spain) by consecutive sampling design (n=112).


METHODS
To apply the screening and diagnosis criteria from Third International Conference of GDM. To value obstetric outcome history, anthropometric parameter before, treatment and delivery type and perinatal complications. Statistic analysis: A chi2 test, with Fisher's correction was used.


RESULTS
A 63% of women were diagnosed of GDM with normal third-hour plasma glucose measurement (Group 1). In 21.4% this value was increase (> 145 mg/dL) but it was not necessary to diagnosis (Group 2). In 15.1%, the third-hour plasma glucose measurement was essential to diagnose GDM (Group 3). Insulin therapy was recommended in 17% (Group 3) and 5% (Group 1 and 2). There are not significant difference between groups about perinatal complications and cesarean delivery incidence.


CONCLUSIONS
We suggest it is not recommended the omission of the third-hour plasma glucose measurement of OGTT because a 15.1% were undiagnosed and would be a substantial decrease in sensitivity. In addition, that group was higher rate insulin therapy.
Núñez-García
Diego
D
Unidad de Investigación Distrito Aljarafe (Sevilla-España), Departamento de Medicina, Universidad de Sevilla. diegonu@terra.es
Pascual-de-la-Pisa
Beatriz
B
Rufo-Romero
Ana
A
Fernández-Fernández
María Isabel
MI
D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D011247:Pregnancy; D013997:Time Factors
D001786:Blood Glucose