Fasting capillary glucose as a screening test for gestational diabetes mellitus.
OBJECTIVE
To evaluate fasting capillary glucose as a screening test for gestational diabetes mellitus (GDM) compared with traditional risk factors and repeated random capillary glucose measurements.


METHODS
Cross-sectional, population-based study.


METHODS
Maternal Health Care Clinics in Orebro County, Sweden.


METHODS
An unselected population of women without diabetes.


METHODS
Fasting capillary glucose levels were measured at gestational weeks 28-32. Random capillary glucose levels were measured four to six times during pregnancy. Traditional risk factors for GDM were registered. GDM was diagnosed using a 75-g oral glucose tolerance test.


METHODS
Sensitivity, specificity, likelihood ratios.


RESULTS
In 55 of 3616 women participating in the study, GDM was diagnosed before 34 weeks of gestation. For fasting capillary glucose cutoff values between 4.0 and 5.0 mmol/l, sensitivity was in the range between 87 and 47% and specificity between 51 and 96%. Using a combined screening model of traditional risk factors with fasting capillary glucose at various cutoff values increased the sensitivity only slightly compared with using fasting capillary glucose alone.


CONCLUSIONS
In this Swedish, unselected, low-risk population, fasting capillary glucose measurements were found to be an acceptable and useful screening test for GDM.
Fadl
H
H
Department of Obstetrics and Gynaecology, Orebro University Hospital, Sweden. helena.fadl@orebroll.se
Ostlund
I
I
Nilsson
K
K
Hanson
U
U
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods* / Q000592:standards; D012372:ROC Curve; D012680:Sensitivity and Specificity
D001786:Blood Glucose