title: Predicting the need for medical therapy in patients with mild gestational diabetes.
abstract: OBJECTIVE
  The enforcement of a one-step gestational diabetes mellitus (GDM) diagnosis would capture more patients with milder forms of glucose intolerance thereby increasing the incidence. We propose to identify characteristics predicting the need for medical therapy in such patients.
  
  
  METHODS
  Retrospective chart review of patients with mild GDM, defined as a fasting plasma glucose (FPG) < 95 mg/dL on the 3-hour 100-g oral glucose tolerance test (OGTT). Patients requiring medical therapy for glucose control were compared with diet-controlled patients. A predictive model was constructed with variables of significance.
  
  
  RESULTS
  Included were 143 patients requiring medical therapy and 224 diet-treated patients. Mean FPG on 3-hour OGTT, prepregnancy body mass index (BMI), and BMI at 26 to 30 weeks were all significantly higher in patients requiring therapy. Combining several variables produced a predictive model with 76% sensitivity, 52% specificity, 48% positive predictive value, and 78% negative predictive value.
  
  
  CONCLUSIONS
  Antenatal factors (alone or in combination) do not allow for prediction of the possible need for therapy in mild GDM patients.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Hector
authors.initials: H
authors.lastname: Mendez-Figueroa
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Julie
authors.initials: J
authors.lastname: Daley
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Vrishali V
authors.initials: VV
authors.lastname: Lopes
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Coustan
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy*; D005260:Female; D005865:Gestational Age; D018149:Glucose Intolerance / Q000175:diagnosis; D005951:Glucose Tolerance Test / Q000379:methods / Q000592:standards; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents