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Poster Session 3

(778) Which cutoff of the 50-gram GCT has a higher predictive value for gestational diabetes mellitus?

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Israel Yoles, MD

    Gynecologist
    Clalit Health Services, THe Central District
    Beit Gamliel, HaMerkaz, Israel

    • Coauthor(s)

  • TB

    Tuvia Baevsky, MD

    Clalit Health Services, THe Central District
    Rishon Le Tzion, HaMerkaz, Israel

Objective: The 50-gram glucose challenge test (GCT) is used as the initial step in screening for gestational diabetes mellitus (GDM). If the GCT result exceeds the institutional threshold, a 100-gram oral glucose tolerance test (OGTT) is performed. The objective of this study was to determine which GCT result is high enough to predict a diagnosis of GDM

Study Design: The study included all pregnant women who underwent a GCT in in a large Health Maintenance Organization. The study included all pregnant women who underwent a GCT between July 2002 and July 2024. We analyzed various GCT values to determine the percentage of women with at least one abnormal value in the subsequent OGTT. GCT was performed if the value was 140 mg/dL or higher. Normal results for OGTT were defined as follows: fasting < 95 mg/dL, 60 minutes < 180 mg/dL, 120 minutes < 155 mg/dL, and 180 minutes < 140 mg/dL

Results:

During the study period, 95,562 GCTs were performed, of which 20,797 (21.7%) resulted in a value of 140 mg/dL or higher. Overall, 3,068 women (15%) exhibited at least one abnormal value in the OGTT. The incidence of women with abnormal OGTT results for each GCT group ranged from 24% to 80% (Table 1). The incidence of abnormal OGTT results in each GCT group increased with age, with older women having a higher incidence of these results (Table 2)

Conclusion: In this large cohort, even significantly elevated GCT values could be followed by normal OGTT results, especially in young pregnant women. Therefore, it is recommended to perform an OGTT for every GCT result above the institutional cutoff