Gestational diabetes: using a portable glucometer to simplify the approach to screening.
BACKGROUND
In populations at a high-risk for gestational diabetes (GDM), the recommendation of screening every pregnant woman with the oral glucose tolerance test (OGTT) is very demanding.


OBJECTIVE
To assess the usefulness of the portable, plasma optimized glucometer in simplifying the approach to screening of GDM.


METHODS
1,662 pregnant women underwent the one-step 75 g OGTT for routine screening of GDM, as defined by the criteria of the American Diabetes Association. The glucometer was used to measure the initial fasting venous whole blood glucose (FBG) to assess its value as a screening test in predicting the need to proceed with the OGTT.


RESULTS
186 (11.2%) women had GDM. The area under the receiver operating characteristic curve (AUC) of the FBG was 0.876 (95% CI 0.847-0.906). A FBG threshold (at an acceptable sensitivity of 85%) independently could 'rule-out' GDM in 1,138 (68.5%) women; i.e. over two-thirds of the women would not need to continue with the cumbersome OGTT.


CONCLUSIONS
Using the glucometer to initially measure the venous FBG as a screen can help to significantly reduce the number of OGTTs needed for the diagnosis of GDM. This algorithm offers a simple, practical, cost-effective and patient-friendly approach for the screening of GDM.
Department of Pathology, Faculty of Medicine, UAE University, Al Ain, United Arab Emirates. magarwal7@gmail.com
Mukesh M
MM
Agarwal
Gurdeep S
GS
Dhatt
Mohamed-Faouzi
MF
Safraou
D019540:Area Under Curve; D001786:Blood Glucose / Q000032:analysis*; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D003955:Diagnostic Tests, Routine / Q000295:instrumentation; D005260:Female; D006801:Humans; D008403:Mass Screening; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve
D001786:Blood Glucose