title: Evaluation of the value of fasting plasma glucose in the first prenatal visit to diagnose gestational diabetes mellitus in china.
abstract: OBJECTIVE
  To evaluate the value of fasting plasma glucose (FPG) value in the first prenatal visit to diagnose gestational diabetes mellitus (GDM).
  
  
  METHODS
  Medical records of 17,186 pregnant women attending prenatal clinics in 13 hospitals in China, including the Peking University First Hospital (PUFH), were examined. Patients with pre-GDM were excluded; data for FPG at the first prenatal visit and one-step GDM screening with 75-g oral glucose tolerance test (OGTT) performed between 24 and 28 weeks of gestation were collected and analyzed.
  
  
  RESULTS
  The median ± SD FPG value was 4.58 ± 0.437. FPG decreased with increasing gestational age. FPG level at the first prenatal visit was strongly correlated with GDM diagnosed at 24-28 gestational weeks (χ(2) = 959.3, P < 0.001). The incidences of GDM were 37.0, 52.7, and 66.2%, respectively, for women with FPG at the first prenatal visit between 5.10 and 5.59, 5.60 and 6.09, and 6.10-6.99 mmol/L. The data of PUFH were not statistically different from other hospitals.
  
  
  CONCLUSIONS
  Pregnant women (6.10 ≤ FPG < 7.00 mmol/L) should be considered and treated as GDM to improve outcomes; for women with FPG between 5.10 and 6.09 mmol/L, nutrition and exercise advice should be provided. An OGTT should be performed at 24-28 weeks to confirm or rule out GDM. Based on our data, we cannot support an FPG value ≥5.10 mmol/L at the first prenatal visit as the criterion for diagnosis of GDM.
authors.affiliation: Peking University First Hospital, Beijing, China.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Zhu
authors.forename: Hui-Xia
authors.initials: HX
authors.lastname: Yang
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Wei
authors.forename: Jie
authors.initials: J
authors.lastname: Yan
authors.forename: Zi-Lian
authors.initials: ZL
authors.lastname: Wang
authors.forename: Xue-Lan
authors.initials: XL
authors.lastname: Li
authors.forename: Hai-Rong
authors.initials: HR
authors.lastname: Wu
authors.forename: Nan
authors.initials: N
authors.lastname: Li
authors.forename: Mei-Hua
authors.initials: MH
authors.lastname: Zhang
authors.forename: Xing-Hui
authors.initials: XH
authors.lastname: Liu
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
authors.forename: Yun-Hui
authors.initials: YH
authors.lastname: Wang
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Niu
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Gan
authors.forename: Li-Ruo
authors.initials: LR
authors.lastname: Zhong
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Wang
authors.forename: Anil
authors.initials: A
authors.lastname: Kapur
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002681:China; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005215:Fasting / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care
chemical_list: D001786:Blood Glucose