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Maternal Medicine Posters
Sensitivity of postnatal fasting plasma glucose in identifying impaired glucose tolerance and frank diabetes in women with gestational diabetes
  1. H Yeeles,
  2. P Madhuvrata,
  3. R Bustani,
  4. T Farrell
  1. Sheffield Teaching Hospitals, Sheffield, United Kingdom

Abstract

Aims To review postnatal glucose tolerance testing (GTT) in women with gestational diabetes mellitus (GDM) and to determine whether there is an essential role for 2 hour GTT in screening for both impaired glucose tolerance and type 2 diabetes.

Methods All women with gestational diabetes diagnosed between January 2008 and June 2011 were included. Patients were offered a post-natal GTT at 6 weeks after delivery. Fasting blood glucose results were compared to the results of 2 hours post glucose challenge.

Results The total number of women with GDM was 811. 191 (24%) women declined or failed to attend their post-natal GTT. 71 (11%) had an abnormal result. Of this, 14 were diagnosed with type 2 diabetes and 57 with impaired glucose tolerance (IGT). 42 (40 IGT and 2 type 2 diabetes) of these with abnormal GTT had fasting glucose ≤6 mmol/l. A fasting glucose of ≥6.1mmol/l correctly identified 29 of 71 cases of abnormal GTT, with a sensitivity of 40%.

Sensitivity 40%, specificity 94%, PPV 50%, NPV 92%

Conclusions Impaired post-natal glucose tolerance has both implications for future pregnancies and long term health. It is also a strong predictor of developing type 2 diabetes. Formal diagnosis, education and subsequent management is therefore essential. GTT is crucial in identifying these patients, since fasting blood glucose alone is not sufficiently sensitive.

Abstract PM.45 Table 1

Results of GTT

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