Fulya GOKDAGLİ SAGİR, Erol ARSLAN, Halenur BOZDAĞ

OBSTETRİCS OUTCOMES AND POSTPARTUM ASSESSMENT OF PATIENTS WITH RESULTS OF BETWEEN 130-140 mg/dl VALUES in 50-gr OGTT PERFORMED DURİNG PREGNANCY

Objectives: Gestational diabetes mellitus screening tests which is 50-gr OGTT generally recommended in 24th-28th weeks of pregnancy. There are two limited value in results, one of this is 130 mg/dl and the second one is 140 mg/dl. We aimed to compare two grup; first is control group is less than 130mg/dl and the second gruop is 130-140md/dl. Material and Methods: In the study; there are 2 groups which emerge 92 patients according to 50-gr OGTT values in the 24th -28th weeks of pregnancy. The first group contains 46 patients whose OGTT values' are under than 130 mg/dl and the second group contains 46 patients whose OGTT values are between 130mg/dl and 140 mg/dl. 75-gr OGTT is tested to patients whose pregnancy are in the end of the 6 weeks. Conclusions: There is no international optimal agreement on diagnosis at the moment for GDM and treatments are challenging. All patients must be protected against hyperglycemia even though their screening test results do not exceed threshold levels.Nowadays the complication rates are very low due to early diagnosis and close chasing. These patients should be followed up after pregnancy for the development of Diabetes Mellitus Type 2.

Anahtar Kelimeler:

Gestational diabetes, pregnancy, oral glucose tolerance test

PDF

___

1- Classification and diagnosis of diabetes. Diabetes Care. American Diabetes Association (2016) Jan;39 Suppl 1:S13-22 DOİ: 10.2337/dc16-S005
2-Turok DK, Ratcliffe SD, Baxley AG. Management of gestational diabetes mellitus. Am Fam Physician 2003;68: 1769–72.
3-Dornhorst A, Paterson CM, Nicholls JS, Wadsworth J, Chiu DC, Elkeles RS, et al. High prevalence of gestational diabetes in women from ethnic minority groups. Diabet Med 1992;9: 820–825.
4-Marquette GP, Klein VR, Niebyl JR. Efficacy of screening for gestational diabetes. Am J Perinatol 1985;2: 7–9.
5-Kim C, Tabaei BP, Burke R, McEwen LN, Lash RW, Johnson SL, et al. Missed opportunities for type 2 diabetes mellitus screening among women with a history of gestational diabetes mellitus. Am J Public Health 2006;96: 1643-8.
6-Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of Type 2 diabetes: a systematic review. Diabetes Care 2002;25:1862-8.
7- Chiefari B. Arcidiacono D. Foti A. Brunetti Gestational diabetes mellitus: an updated overview E. Italian Society of Endocrinology (SIE) 2017; Sep;40(9):899-909.
8-Kjos SL, Buchanan TA. Gestational diyabetes mellitus. N Engl J Med 1999;341:1749-1756. 9- Bharat Bassawa, Horace Fletcherb. Screening for gestational diabetes mellitus: J Obstet Gynaecol 2018 Nov;38(8):1035-1038.
10- M vanLeeuwen,a MD Louwerse, Glucose challenge test for detecting gestational diabetes mellitus: a systematic review BJOG 2012 Mar;119(4):393-401.
11-W.Juntarat , W.Rueangchainikhom, 50-grams glucose challenge test for screening of gestational diabetes mellitus in high risk pregnancy J MedAssocThai . 2007 Apr;90(4):617-23.
12- YarivYogev . The association between glucose challenge test, obesity and pregnancy outcome in 6390 non-diabetic women J Matern Fetal Neonatal Med 2005 jan;17(1):29-34
13-K. Feldman Gestational Diabetes Screening: The International Association of the Diabetes and Pregnancy Study Groups Compared With Carpenter-Coustan Screening Obstet Gynecol 2016 . Jan;127(1):10-17.
14-K.P.Fuller and A. F. Borgida, “Gestational diabetes mellitus screening using the one-step versus two-step method in a high risk practice,”ClinicalDiabetes,vol.32,no.4,pp.148–150,2014. 15-Y.-M. Wei, H.-X. Yang, W.-W. Zhu, H.-Y. Yang, H.-X. Li, and .Kapur,“Effects of intervention to mild GDM on outcomes,” Journal of Maternal-Fetal and Neonatal Medicine,vol.28,no.8, pp.928–931,2015.
16-J.K.Ethridge,P.M.Catalano,“Perinata loutcomes associated with the diagnosis of gestational diabetes made by the international association of the diabetes and pregnancy study groups criteria,” Obstetrics and Gynecology, vol.124,no.3,pp.571–578,2014.
17- S. Liao, J. Mei, W. Song et al., “The impact of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) fasting glucose diagnostic criterion on the prevalence and outcomes of gestational diabetes mellitus in Han Chinesewomen,”DiabeticMedicine,vol.31,no.3,pp.341–351, 2014.
18- K. Benhalima, M. Hanssens, R. Devlieger, J. Verhaeghe, and C. Mathieu, “Analysis of pregnancy out comes using the new IADPSG recommendation compared with the carpenter and coustan criteria in an area with a low prevalence of gestational diabetes,” International Journal of Endocrinology, vol. 2013, ArticleID248121,2013.
19- A. Lapolla, M. G. Dalfr`a, E. Ragazzi, A. P. De Cata, and D. Fedele, “New International Association of the Diabetes and Pregnancy Study Groups(IADPSG) recommendations for diagnosing gestational diabetes compared with former criteria. Retrospective study on pregnancy outcome,”Diabetic Medicine,vol. 28,no.9,pp.1074–1077,2011.
20- C. Assaf-Balut, E. Bordi´u, L. Del Valle et al., “The impact of switching to the one-step method for GDM diagnosis on the rates of postpartum screening at tendance and glucose disorder BioMed Research International in women with prior GDM. The San Carlos Gestational Study,” Journal of Diabetes and Its Complications,vol.30,no.7,pp.1360– 1364,2016.
21- J. M. Kong, K. Lim, and D. M. Thompson, “Evaluation of the International Association of the Diabetes in Pregnancy Study Group New Criteria: gestational diabetes project,” Canadian Journal of Diabetes,vol.39,no.2,pp.128–132,2015. 22-Metzger BE. Summary and recommendations of the Third International Workshop: Conference on Gestational Diyabetes Mellitus. Diyabetes 1991;40(Suppl 2):197-201.
23- American Diyabetes Association. Diagnosis and Classification of Diyabetes Mellitus. Diyabetes Care 2004; 27 suppl: 5-10.
24- Bonomo M, Corica D, Mion E, et al. Evaluating the therapeutic approach in pregnancies complicated by borderline glucose intolerance. A randomized clinical trial. Diabet Med 2005;22:1536-41.
25- Weijers RNM, Bekedam DJ, Simulders YM. Detarminants of mild gestational hyperglycemia and gestational diabetes mellitus in a large Dutch multiethnic cohort. Diabetes Care 2002;25:72-7.
26- Uludağ S, Gezer A. Gebelik Diabeti.Türk Jinekoloji ve Obstetrik Derneği, Uzmanlık Sonrası Güncel Gelişmeler Dergisi. 2005;1(2):55-61
27- Schmidt MI, Duncan BB, Reichelt AJ, Branchtein L, Matos MC ve ark. Gestational Diabetes Mellitus Diagnosed With a 2-h 75-g Oral Glucose Tolerance Test and Adverse Pregnancy Outcomes. Diabetes Care 2001; 24:1151-1155.
28- Langer O, Brustman L, Anyaegbuman A, Mazze R. The significance of one abnormal glucose tolerance test value on adverse outcome in pregnancy. Am J Obstet Gynecol 1987;157:758-763.
29- Forsbach G, Contreras-Soto JJ, Fong G, Flores G, Moreno O. Prevalence of gestational diyabetes and macrosomic newborns in a Mexican population. Diyabetes Care 1988;11:235-238.
30- Aberg A, Westbom L, Kallen B. Congenital malformations among infants whose mothers had gestational diyabetes or preexisting diyabetes. Early Hum Dev 2001;61:85-95.
31- Gerardo Forsbach-Sánchez, Hector E. Tamez-Peréz, Julia Vazquez-Lara. Diyabetes and Pregnancy. Archives of Medical Research, 2005;36(3):291-299.
32- Fougner KJ, Vanky , Carlsen SM. Metformin has no major effects on glucose homeostasis in pregnant women with PCOS: results of a randomized double-blind study. Scand J Clin Lab Invest. 2008 Jul 24: 1-6. (Ebup ahead of print)
33- Buschard, I Buch, M Molsted-Pederson, P Hougaard, C Koni: Increased incidnce of true type I diabetes acquired during pregnancy. British Med J 294:275,1987