Sign up for our complimentary
weekly e-journal

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 08 February, 2012 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: Issue 747 | Diabetes Clinical Mastery Series Issue 206 | SGLT-2 Inhibitors Special Edition September 2014 | Issue 746 | Diabetes Clinical Mastery Series Issue 205 |

2014 Most Popular Articles:

Abbott Announces Approval of Its New Unique Continuous Glucose Monitor
Posted September 05, 2014
Diabetic Neuropathy Improved with Vegan Diet
Posted August 22, 2014
Low Carb Beats Low Fat
Posted September 05, 2014
CDC: 40% of American Adults Will Develop Diabetes
Posted August 22, 2014
Empagliflozin (Jardiance) SGLT-2 Inhibitor Now Available in Pharmacies
Posted August 29, 2014
Lilly's Basal Insulin Peglispro Demonstrated HbA1c Superiority against Lantus
Posted September 05, 2014
Pistachios Associated with an Improved Metabolic Risk Profile in Prediabetes
Posted August 29, 2014
New Ultra-Rapid-Acting Insulin Formulation
Posted August 22, 2014
FDA Approves J&J's Invokamet Combo (SGLT-2 + Metformin)
Posted August 15, 2014
Sensor Implant Measures Blood pH in Type 1 Diabetes
Posted August 29, 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. Bernstein | 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 | Sheri R. Colberg PhD | Sherri Shafer | Stanley Schwartz, MD, FACP, FACE | Steve Pohlit | Steven V. Edelman, M.D. | Timothy S. Hollingshead |

Cast Your Vote
Now that once-weekly dulaglutide has been approved, will you be prescribing it?
CME/CE of the Week
Presented by CardioCareLive
Category: Cardiology



Search Articles On Diabetes In Control