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Title: Easting plasma glucose is a useful test for the detection of gestational diabetes
Authors: Reichelt, A. J.
Spichler, E. R.
Branchtein, L.
Nucci, L. B.
Franco, L. J.
Schmidt, M. I.
Univ Fed Rio Grande Sul
Pontificia Univ Catolica Rio Grande do Sul
Universidade Federal de São Paulo (UNIFESP)
Minist Hlth
Issue Date: 1-Aug-1998
Publisher: Amer Diabetes Assoc
Citation: Diabetes Care. Alexandria: Amer Diabetes Assoc, v. 21, n. 8, p. 1246-1249, 1998.
Abstract: OBJECTIVE - To evaluate fasting plasma glucose as a screening lest for states of gestational diabetes.RESEARCH DESIGN and METHODS - Baseline data of a cohort conducted in general prenatal care units in Brazil, enrolling 5,579 women aged greater than or equal to 20 years with gestational ages of 24-28 weeks at the time of testing and no previous diagnosis of diabetes. A standardized 2-h 75-g oral glucose tolerance test was performed in 5,010 women. Gestational diabetes and its subcategories-diabetes and impaired glucose tolerance-were defined according to the 1994 World Health Organization panel recommendations. We evaluated screening properties of calculated sensitivity and specificity for fasting plasma glucose with receiver operator characteristic curves.RESULTS - for detection of the subcategory diabetes, a fasting plasma glucose of 89 mg/dl jointly maximizes sensitivity (88%) and specificity (78%), identifying 22% of the women as test-positive. for detection of impaired glucose tolerance, a value of 85 mg/dl jointly maximizes sensitivity and specificity (68%), identifying as test-positive 35% of the women. lowering the cut point to 81 mg/dl increases sensitivity to 81%, but decreases specificity to 54%, labeling as test-positive 49% of the women.CONCLUSIONS - Fasting plasma glucose is a useful test for the screening of both subcategories of gestational diabetes, a threshold of 85 mg/dl being an acceptable option. Effective screening for the subcategory diabetes can be achieved using a cut point of 89 mg/dl. If greater emphasis is placed on the detection of impaired glucose tolerance, a lower value, 81 mg/dl, may be needed.
ISSN: 0149-5992
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