Gazi YILDIRIM, Canan YILMAZ, Fırat ERSAN, Rukset ATTAR, Aslı SOMUNKIRAN, Narter YEŞİLDAĞLAR, Ateş KARATEKE, D. Cem FIÇICIOĞLU

Gebelik sırasında 50 gr glukoz tarama testi pozitif olan hastaların 100 gr oral glukoz tolerans testi sonuçlarının retrospektif olarak değerlendirilmesi

Amaç: Gestasyonel diabet (GDM) tanısı koymak için 1 saatlik 50 gr glukoz tarama testinde (Glucose Challenge Test-GCT) bir eşik değer belirlemek. Materyal ve Metod: Bu retrospektif çalışmaya glukoz tarama testi pozitif çıkan 95 gebe dahil edildi. Bu gruba 1 hafta sonra 100 gr oral glukoz tolerans testi (OGTT) uygulandı. Test sonucuna gore diabet tanısı alan ve almayan hastaların verileri üzerinde kıyaslama yapıldı. Bulgular: Bu 95 gebenin 58'inde (%61.1) OGTT sonucu da pozitif olarak geldi ve GDM tanısı aldılar. Sonucu pozitif olduğu halde OGTT tahlili normal olanların oranı ise %38.9 (37/95) idi. Normal gebelerin GCT değer ortalaması 155.8±9.3 mg/dl, GDM grubunun ise 165.8±14.7 mg/dl idi (p=0.001). GCT eşik değeri 140 mg/dl alındığında sensitivite %86 iken spesifisite %19 e düşmekte idi. Eşik değer 200 mg/dl olarak kabul edildiğinde ise sensitivite %5, spesifisite ise %100 idi. Sonuç: GDM tanısı sadece GCT deki tek bir eşik değer göre konulamaz. Günümüzde hala GDM tanısının iki basamaklı GCT ve OGTT ile yapılması en uygun program gibi görülmektedir.

Anahtar Kelimeler:

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A retrospective analysis of the results of 100 gr oral glucose tolerans test among the pregnant patients whose 50 gr glucose challenge test were positive

Objective: To determine a cut-off value on the 50 gr glucose challenge test (GCT) for the diagnosis of gestational diabetes mellitus (GDM). Materials and Methods: Ninety five pregnant patients whose 50 gr GCT are positive were included in this retrospective trial. OGTT was administered after one week to these patients. The findings were evaluated based on the test results. Results: Fifty eigth of ninety five patients (61.1%) patients got GDM diagnosis according to their OGTT results. Thirty seven of this ninety five (38.9%) patients were accepted as a normal based on OGTT results. In normal group , the mean of the GCT results was 155.8±9.3 mg/dl, in GDM group, the mean of the GCT results was 165.8±14.7 mg/dl (p=0.001). If the level of 140 mg/dl was accepted as a cut-off value for the diagnosis of GDM, sensitivity was 86% and spesifity was 19%. But when the cut-off level increased to 200 mg/dl, sensitivity decreased to 5%, spesifity increased to 100%. Conclusion: Diagnosis of GDM cannot be made just only with a certain cut-off level on GCT. Currently, it looks that two step evaluation with GCT and OGTT is most suitable and acceptable way to determine GDM in pregnancy.

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