title: Screening for gestational diabetes by measuring fasting plasma glucose levels.
abstract: OBJECTIVE
  (a) To test the sensitivity and specificity of measuring fasting plasma glucose levels (FPG) as a screening test for gestational diabetes mellitus (GDM). (b) To compare predicting levels of FPG levels with the one-hour, oral 50g non-fasting glucose challenge test (GCT) for predicting GDM.
  
  
  METHODS
  One thousand and six hundred pregnant women from the Health Centres, antenatal clinics and Salmaniya Medical Complex were screened by the GCT after 50g of oral glucose during 26-32 weeks gestation, giving a 13.5% incidence of GDM (using the Third International Workshop cutoff values of 7.8 mmol /l). All patients also had an FPG estimation followed by the three-hour oral glucose tolerance test (oGTT). Seventy eight percent of the patients were Bahraini, 19% Asian and 3% other nationalities. Their mean age was 27.2+0.2 years. Receiver-operating curves (ROC) were used to test the ability of the FPG and the oGTT to differentiate patients with GDM and identify the cut off values for predicting a diagnosis of GDM.
  
  
  RESULTS
  FPG levels of 5.6 mmol /l and 5.4 mmol /l yielded sensitivities and specificities of 94% and 93% respectively. Measuring FPG as a screening test required a diagnostic oGTT in 32% compared with 13% when the GCT was used.
  
  
  CONCLUSIONS
  Using FPG levels at a cutoff value of ≥ 5.5 mmol /l is an easier, more acceptable test for patients compared to the GCT. Using the FPG levels is also more cost effective and allows nearly 70% of women to avoid the oGTT.
authors.affiliation: Department of Obstetrics and Gynaecology, Department of Anaesthesia and Intensive Care, Arabian Gulf University, College of Medicine and Medical Sciences, Salmaniya Medical Complex, P.O.Box 26752, Manama, Kingdom of Bahrain.
authors.forename: Khalil E
authors.initials: KE
authors.lastname: Rajab
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Skerman
authors.forename: Abdulla A
authors.initials: AA
authors.lastname: Issa
keywords: fasting plasma glucose levels; gestational diabetes; pregnancy; screening
references.citation: Diabet Med. 2002 May;19(5):351-8
references.pmid: 12027921
references.citation: Diabetes Care. 1998 Aug;21 Suppl 2:B107-12
references.pmid: 9704236
references.citation: Diabetes Care. 1997 Jul;20(7):1183-97
references.pmid: 9203460
references.citation: Diabetes Metab. 2001 Jun;27(3):347-58
references.pmid: 11431600
references.citation: Int J Gynaecol Obstet. 2000 Feb;68(2):147-8
references.pmid: 10717820
references.citation: Diabetes Care. 1998 Aug;21(8):1246-9
references.pmid: 9702428
references.citation: N Engl J Med. 1997 Nov 27;337(22):1591-6
references.pmid: 9371855
references.citation: Diabetes Care. 1998 Aug;21 Suppl 2:B161-7
references.pmid: 9704245
references.citation: Obstet Gynecol Clin North Am. 2001 Sep;28(3):513-36
references.pmid: 11512498
references.citation: Diabetes Care. 1998 Apr;21(4):666-7
references.pmid: 9571361
references.citation: Am J Obstet Gynecol. 1995 Feb;172(2 Pt 1):607-14
references.pmid: 7856693
references.citation: Diabetes Res Clin Pract. 2001 Jan;51(1):67-73
references.pmid: 11137184
references.citation: Diabetologia. 1999 Jun;42(6):647-54
references.pmid: 10382583
references.citation: Diabetes Care. 1997 Dec;20(12):1859-62
references.pmid: 9405907
references.citation: Diabetes Care. 2001 May;24(5):954-5
references.pmid: 11347763
references.citation: BMJ. 1999 Sep 25;319(7213):812-5
references.pmid: 10496823