Hacer UYANIKOĞLU, Adnan İNCEBIYIK, Emel YİĞİT KARAKAŞ

Gestasyonel Diyabet Taramasında 50 gram Glukoz Yüklemesi Gerekli mi?

Amaç: Gestasyonel diyabet taramasında kullanılan 50 g glukoz yükleme testinin gerekli olup olmadığını araştırmak. Gereç ve Yöntemler: Bu retrospektif çalışmada Özel OSM Hastanesi Kadın Hastalıkları ve Doğum polikliniğine antenatal takip için başvurmuş olan 143 gebe kadına dair kayıtlar incelendi. Gestasyonel diyabet taraması uygulanan tüm gebeler 24-28. gestasyonel haftalar arasında idi. Hastalar iki gruba ayrıldı. Birinci gruba (n=76) 50 g glukoz, ikinci gruba (n=67) 75 g glukoz yükleme testi yapılmıştı. Birinci grupta test sonucu pozitif olan gebelere 100 g oral glukoz yükleme testi yapılmıştı. Her iki yükleme testi ve 100 g oral glukoz yükleme testi, Amerikan Diyabet Birliği'nin önerdiği şekilde uygulanmıştı. Bulgular: 50 g glukoz yükleme testi yapılan birinci gruptaki hastaların yaş ortalaması 27,4 ± 5,5 olup 23'ünde test pozitif sonuçlanmıştı. Bu hastaların da 13'ünde (%17) 100 g oral glukoz yükleme testi pozitif sonuçlanmıştı. 75 g glukoz yükleme testi yapılan yapılan ikinci gruptaki hastaların yaş ortalaması 26,9 ± 5,9 olup 14'ünde (%21) test pozitif sonuçlanmıştı. İkinci grupta daha sık test pozitifliği saptanmasına rağmen, iki grup arasında istatistiksel fark bulunmadı (p>0,05). Tartışma ve Sonuç: Her iki test ile benzer sıklıkta gestasyonel diyabet tanısı alan hasta saptanmıştır. Bu nedenle iki aşamalı olan ve buna bağlı olarak daha fazla glukoz alınmasına neden olan 50 g glukoz yükleme testinin gerekli olmayabileceği sonucuna varılabilir.

Is the 50-gram Oral Glucose Tolarence Test (OGTT) Essential for the Screening of Gestational Diabetes?

Aim: We aimed to investigate whether the 50-gram oral glucose tolerance test is essential for the screening of gestational diabetes. Materials and methods: Clinical records related to 143 pregnant women who had applied to the Obstetrics and Gynecology Department of the OSM Hospital for antenatal care were included in this retrospective study. All of the pregnant women between 24 and 28 weeks of gestation had been screened for gestational diabetes. The patients were separated into two groups. The 50gram oral glucose tolerance test had been performed in the first group (n=76), and the 75-gram oral glucose tolerance test in the second group (n=67). The women who had tested positive in the first group had undergone the 100-gram oral glucose tolerance test. All of the tests were performed in accordance with the recommendation of the American Diabetes Association.Results: In the first group who had undergone the 50-g OGTT, the mean age was 27.4 ± 5.5 (18-42) and 23 patients had tested positive. Of these, 13 patients (17%) had also tested positive with the 100-g OGTT. In the second group who had undergone the 75-g OGTT, the mean age was 26.9 ± 5.9 (17-43) and 14 patients (21%) had tested positive. Although the second group had tested positive for GDM more frequently, no statistically significant difference was found between the two groups (p>0.05).Discussion and Conclusion: The 50-g and 75-g OGTTs revealed a diagnosis of GDM at a similar frequency. Therefore, it may be concluded that the 50-g OGTT that consists of two stages and hence leads to a higher intake of glucose may not be essential.

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