Searching for alternative methods of diagnosing gestational diabetes mellitus in a Mexican urban population.
BACKGROUND
The aim of the study was to determine whether a predictive value for the diagnosis of gestational diabetes mellitus (GDM) could be established using different glucose screening test thresholds in Mexican urban pregnant women.


METHODS
A group of 635 pregnant women (12-33 weeks of gestation) with serum glucose screening values of > or = 7.2 mmol (> or = 130 mg/dl) were evaluated with a 100-g 3-h oral glucose tolerance test (OGTT). The positive predictive values (PPVs) for serum glucose screening values of > or = 7.2 mmol to > or = 11.1 mmol (> or = 130 to > or = 200 mg/dl), age, and pregestational BMI were calculated.


RESULTS
Of the women, 304 (47.8%) had a normal OGTT, 126 (19.8%) had impaired glucose tolerance, and 205 (32.3%) had GDM. A serum glucose screening value of > or = 9.4 mmol (> or = 170 mg/dl) had a positive predictive value (PPV) of 0.85 and the relative risk for GDM was 6.62 (95%CI: 4.40-9.97, p=0.001). Omission of the 3-h value during OGTT yielded a sensitivity of 91.2% (187/205).


CONCLUSIONS
In this group of Mexican urban pregnant women, a serum glucose screening value of > or = 9.4 mmol (> or = 170 mg/dl) had a PPV of 85%. An algorithm is proposed to reduce the number of OGTTs performed in pregnant women attending prenatal care by 36.2%.
Ortega-Gonzalez
Carlos
C
Department of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico. ortegacarlos@hotmail.com
Ballesteros
Alberto
A
Casanueva
Esther
E
Fonseca
Tania
T
Cacique
Edgar
E
Parra
Adalberto
A
D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008800:Mexico; D011247:Pregnancy; D014505:Urban Population
D001786:Blood Glucose