4.4 mmol/L Is Optimal Fasting Glucose Cutoff for GDM Screening

Chinese study concludes strategy could halve oral glucose tolerance tests needed in pregnancy

MONDAY, April 15 (HealthDay News) -- A fasting plasma glucose value of 4.4 mmol/L is the optimal cut point for determining which pregnant Chinese women need a 75-g 2-h oral glucose tolerance test offered at 24 to 28 weeks' gestation, according to a study published online March 27 in Diabetes Care.

Wei-Wei Zhu, M.D., from Peking University First Hospital in China, and colleagues analyzed the medical records and results of a 75-g 2-h oral glucose tolerance test (OGTT) from 24,854 pregnant women without known pre-gestational diabetes mellitus (pre-GDM).

The researchers found that a fasting plasma glucose cutoff value of 5.1 mmol/L identified 3,149 pregnant women (12.1 percent) with GDM. A fasting plasma glucose cutoff value of 4.4 mmol/L ruled out GDM in 15,369 women (38.2 percent) women, which would miss 12.2 percent of patients with mild GDM. The positive predictive value is 0.322, and the negative predictive value is 0.928.

"Fasting plasma glucose at 24 to 28 weeks' gestation could be used as a screening test to identify GDM patients in low-resource regions," the authors write.

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