Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
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Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests

  • Kang, Sunyoung (Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Min Hyoung (Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine) ;
  • Kim, Moon Young (Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine) ;
  • Hong, Joon-Seok (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kwak, Soo Heon (Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Choi, Sung Hee (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Lim, Soo (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Park, Kyong Soo (Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jang, Hak C. (Department of Internal Medicine, Seoul National University College of Medicine)
  • Received : 2018.08.21
  • Accepted : 2018.11.23
  • Published : 2019.10.30
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Abstract

Background: Women with one abnormal value (OAV) in a 100 g oral glucose tolerance test (OGTT) during pregnancy are reported to have an increased risk of adverse pregnancy outcomes. However, there is limited data about whether women with OAV will progress to gestational diabetes mellitus (GDM) when the OGTT is repeated. Methods: To identify clinical and metabolic predictors for GDM in women with OAV, we conducted a retrospective study and identified women with OAV in the OGTT done at 24 to 30 weeks gestational age (GA) and repeated the second OGTT between 32 and 34 weeks of GA. Results: Among 137 women with OAV in the initial OGTT, 58 (42.3%) had normal, 40 (29.2%) had OAV and 39 (28.5%) had GDM in the second OGTT. Maternal age, prepregnancy body mass index, weight gain from prepregnancy to the second OGTT, GA at the time of the OGTT, and parity were similar among normal, OAV, and GDM groups. Plasma glucose levels in screening tests were different (151.8±15.7, 155.8±14.6, 162.5±20.3 mg/dL, P<0.05), but fasting, 1-, 2-, and 3-hour glucose levels in the initial OGTT were not. Compared to women with screen negative, women with untreated OAV had a higher frequency of macrosomia. Conclusion: We demonstrated that women with OAV in the initial OGTT significantly progressed to GDM in the second OGTT. Clinical parameters predicting progression to GDM were not found. Repeating the OGTT in women with OAV in the initial test may be helpful to detect GDM progression.

Keywords

Acknowledgement

We really thank to obstetricians of Cheil General Hospital & Women's Healthcare Center for their contributions.

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