Main Newsletter
Mastery Series
Therapy Series
 
Bookmark and Share | Print Article | Items for the Week Previous | All Articles This Week | Next
This article originally posted and appeared in  Women's HealthIssue 612

50GM Glucose Challenge Test an Acceptable Screen for Gestational Diabetes

The 50-g glucose challenge test is an "acceptable" screening test for GDM but it can't replace the OGTT....

Advertisement

GDM affects between 2% and 9% of pregnant women in Western countries and is often asymptomatic. Research has shown that treating GDM with diet or insulin improves both perinatal and maternal outcomes, making detection important. Yet the best way to identify women with GDM is unclear.

In their report, Dr. Marsha van Leeuwen from Academic Medical Center, Amsterdam and colleagues say that while the 50-g glucose challenge test is not recommended in the majority of national guidelines, "it could be a useful test in the diagnostic work up of GDM."

In a systematic review and meta-analysis, they evaluated it as a first-step screening test for GDM and as a replacement for the OGTT, the current diagnostic test.

Altogether they looked at 26 relevant studies (in 13,564 women) that compared the 50-g glucose challenge test to the OGTT before 32 weeks gestation. The reference standard was the 75-g OGTT in six studies and the 100-g OGTT in the other 20 papers.

In studies of women with risk factors for GDM, such as a prior affected pregnancy, the 50-g glucose challenge test had a pooled sensitivity of 0.74 and a pooled specificity of 0.77 (for a threshold value of 7.8 mmol/L). The test had "modest" accuracy for GDM, with positive and negative likelihood ratios of 3.2 and 0.34, respectively, the researchers say.

Results were similar in studies that consecutively recruited participants, with sensitivity, specificity and positive and negative predictive likelihood ratios of 0.74, 0.85, 4.9 and 0.31, respectively.

The researchers found that increasing the threshold for disease (OGTT result) increased the sensitivity of the challenge test and decreased the specificity.

Dr. van Leeuwen and colleagues say that while higher detection rates "would be preferable," the 74% detection rate of the 50-g glucose challenge test "might be acceptable if used a screening test."

They emphasize, however, that to use the 50-g glucose challenge test as a definite diagnostic test for GDM, in place of the OGTT, "higher accuracy measures are warranted."

On the other hand, they say clinicians could consider a one-step method, using the OGTT for screening for example in selected women, such as those with risk factors for GDM. This could be less burdensome for patients, and more cost-effective than a two-step method in which a glucose loading test might be performed twice.

Online January 20 in the British Journal of Obstetrics and Gynecology (BJOG)

Advertisement


 

Bookmark and Share | Print | Category | Home

This article originally posted 08 February, 2012 and appeared in  Women's HealthIssue 612

Past five issues: Diabetes Clinical Mastery Series Issue 211 | Issue 751 | Humulin Insulin Special Edition October 2014 | Diabetes Clinical Mastery Series Issue 210 | Issue 750 |

2014 Most Popular Articles:

FDA Approves Once-Weekly GLP-1 Diabetes Treatment Regimen for T2DM
Posted September 25, 2014
Stanley Schwartz, MD: A New Way of Classifying Diabetes - The Beta-Cell Centric Approach
Posted September 29, 2014
Two Positive Phase 3 Trials for ITCA 650 (Exenatide, a GLP-1 Agonist) in Type 2 Diabetes
Posted October 10, 2014
EASD: Insulin Pumps Lower Mortality Rate 29% Compared to Multiple Injections in T1DM
Posted October 03, 2014
Best Insulin Regimen for Type 1's
Posted October 10, 2014
GLP-1 Agonist Medications Chart
Posted September 23, 2014
FDA Approves an Eye Drug for Diabetic Patients
Posted September 25, 2014
Non-Caloric Artificial Sweeteners May Induce Glucose Intolerance
Posted October 10, 2014
Handbook of Diabetes, 4th Ed., Excerpt #13: Control and Complications
Posted October 13, 2014
Handbook of Diabetes, 4th Edition, Excerpt #11: Diabetic Ketoacidosis, Hyperglycaemic Hyperosmolar State and Lactic Acidosis
Posted September 27, 2014


Browse by Feature Writer & Article Category.
A. Lee Dellon, MD | Aaron I. Vinik, MD, PhD, FCP, MACP | Beverly Price | Charles W Martin, DD | Derek Lowe, PhD | Dr. Brian Jakes, Jr. | Dr. Fred Pescatore | Dr. Tom Burke, Ph.D | Eric S. Freedland | Evan D. Rosen | Ginger Kanzer-Lewis | Greg Milliger | Kristina Sandstedt | Laura Plunkett | Leonard Lipson, M.A. | Louis H. Philipson | Maria Emanuel Ryan, DDS, PhD | Marilyn Porter, RD, CDE | Melissa Diane Smith | Michael R. Cohen, RPh, MS, ScD, FASHP | Paul Chous, M.A., OD | Philip A. Wood PhD | R. Keith Campbell, Professor, B.Pharm, MBA, CDE | Richard K. Bernstein, MD | Sheri R. Colberg PhD | Sherri Shafer | Stanley Schwartz, MD, FACP, FACE | Steve Pohlit | Steven V. Edelman, M.D. | Timothy S. Hollingshead |

Cast Your Vote
Do your teenage patients manage their diabetes well?
CME/CE of the Week
Presented by CardioCareLive
Category: Cardiology



Search Articles On Diabetes In Control