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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award

Poster Session 3

(851) Should fasting blood glucose value on the OGTT be incorporated into initial gestational diabetes counseling?

Friday, January 31, 2025
10:30 AM - 12:30 PM  
Objective: Hypoglycemic agents are used to optimize glycemic control in the treatment of GDM.The aim of this study was to assess the predictability of the fasting blood glucose value(FBS) on the OGTT in predicting the need for hypoglycemic agents in patients with GDM.

Study Design: This study was a single-center retrospective cohort study of singleton pregnancies with GDM between 2018-2023.Diagnosis was made by Carpenter-Coustan(CC) criteria.Initial management involved dietary and lifestyle modifications, with hypoglycemic agents introduced if blood glucose values were above threshold(FBS > 90mg/dl, 2hpp > 120mg/dl or 1hpp > 140mg/dl).Receiver operating characteristic curves(ROC) were generated to determine predictability of FBS on the OGTT for the need for hypoglycemic agents.Predictability of FBS on OGTT was evaluated using the clinical cut-off values of 81mg/dl(based on the Youden’s Index),95mg/dl(based on CC) and 105mg/dl(based on NDDG). Sensitivity, specificity, positive and negative predictive values were calculated.

Results: 1,407 patients diagnosed with GDM,567(40%) were prescribed hypoglycemic agents. There was a statistically significant difference between patients that required hypoglycemic agents in regards to age,BMI,race,and history of GDM.FBS on OGTT was predictive of need for hypoglycemic agents based on the ROC curve with an AUC of 0.76 (95% CI 0.74-0.79),indicating a 76% chance that FBS on GTT can distinguish between patients who did and did not need hypoglycemic agents(Figure 1). The value with the highest Youden’s Index was 81mg/dl.A cut-off value of 95mg/dL had the highest positive predictive value(PPV); of women who had ≥ 95mg/dL FBS on OGTT,75.25% required hypoglycemic agents,whereas 32.9% of patients with a FBS < 95mg/dl needed hypoglycemic agents(Table 1).

Conclusion: Our data suggests that if a patient has a FBS of  ≥ 95mg/dL there is a 75% chance that they will require hypoglycemic agents.This can be used during initial counseling to educate patients diagnosed with GDM on the possibility of the need for hypoglycemic agents and provide reassurance to patient’s with FBS < 95mg/dL.