Departments of Pathology and Medical Education, California University of Science & Medicine, School of Medicine, San Bernardino, California, United States.
Department of Endocrinology, St. Stephen's Hospital, Delhi, India.
Can J Diabetes. 2018 Oct;42(5):500-504. doi: 10.1016/j.jcjd.2017.12.009. Epub 2017 Dec 15.
To evaluate the value of the fasting plasma glucose (FPG) level for simplifying the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic algorithm of gestational diabetes mellitus (GDM) in a South Asian population.
In 6,520 pregnant women undergoing universal screening with the 75 g oral glucose tolerance test (OGTT), the area under receiver operating characteristic curve was used to determine the overall FPG performance to detect GDM (IADPSG criteria). Specifically, 2 different FPG thresholds of the OGTT were used to rule in and rule out GDM so as to decrease the need for the cumbersome OGTT.
GDM was present in 1,193 (18.3%) women. The FPG 1) area under receiver operating characteristic curve (95% CI) was 0.909 (0.898 to 0.920); 2) threshold of ≥5.1 mmol/L independently could rule in GDM in 708 (10.9%) women (100% specificity); 3) threshold of <4.3 mmol/L independently could rule out GDM in an additional 2,389 (36.6%) women (95.6% sensitivity).
By circumventing nearly one half the OGTTs, an initial FPG can simplify the onerous GDM diagnostic IADPSG algorithm in this population parochially and in countries with large South Asian immigrant populations-without compromising medical care.
评估空腹血糖（FPG）水平在简化国际妊娠糖尿病研究组（IADPSG）诊断妊娠期糖尿病（GDM）的南亚人群算法中的价值。
在 6520 名接受 75g 口服葡萄糖耐量试验（OGTT）的孕妇进行普遍筛查中，采用受试者工作特征曲线下面积来确定总体 FPG 检测 GDM（IADPSG 标准）的性能。具体而言，使用 2 种不同的 OGTT FPG 阈值来排除和纳入 GDM，以减少繁琐的 OGTT 需求。
1193 名（18.3%）女性患有 GDM。1）FPG 的受试者工作特征曲线下面积（95%CI）为 0.909（0.898 至 0.920）；2）独立的≥5.1mmol/L 的 FPG 阈值可将 708 名（10.9%）女性纳入 GDM（100%特异性）；3）独立的<4.3mmol/L 的 FPG 阈值可排除另外 2389 名（36.6%）女性的 GDM（95.6%敏感性）。
通过绕过近一半的 OGTT，初始 FPG 可以简化该人群和南亚移民人口较多的国家繁琐的 IADPSG 诊断 GDM 算法，而不会影响医疗服务。
