Comparison between 100-g glucose tolerance test and two other screening tests for gestational diabetes: combined fasting glucose with risk factors and 50-g glucose tolerance test.
Sao Paulo Med J
; 124(1): 4-9, 2006 Jan 05.
Article
em En
| MEDLINE
| ID: mdl-16612455
ABSTRACT
CONTEXT AND OBJECTIVE:
Lack of consensus about which screening tests to use for gestational diabetes mellitus (GDM) and difficulties in performing the gold-standard diagnostic test, the 100-g glucose tolerance test (100-g GTT), justify comparison with alternatives. The aim was to compare this with two other screening tests combined fasting glucose with risk factors (FG + RF) and 50-g GTT. DESIGN ANDSETTING:
Prospective longitudinal cohort study in the Hospital School of Universidade Federal de Mato Grosso do Sul.METHODS:
The three tests were performed independently on 341 pregnant women. Sensitivity (S), specificity (Sp), positive (PPV) and negative (NPV) predictive values, positive (PLR) and negative (NLR) likelihood ratios, and false-positive (FP) and false-negative (FR) rates obtained with FG + RF and 50-g GTT were compared with values from 100-g GTT. The average one-hour post-intake glucose levels (1hPG) with 50-g and 100-g were compared. Students t test was used in the statistical analysis.RESULTS:
FG + RF led more pregnant women (53.9%) to diagnostic confirmation than did 50-g GTT (14.4%). The tests were equivalent for S (86.4 and 76.9%), PPV (98.7 and 98.9%), NLR (0.3 and 0.27) and FR (15.4 and 23.1%). Average 1hPG values were similar 50-g GTT = 106.8 mg/dl and 100-g GTT = 107.5 mg/dl.CONCLUSION:
Diagnostic efficiency with simplicity, practicality and low cost make FG + RF more appropriate for screening for GDM. The equivalence of 1hPG allows a new, cheaper and less uncomfortable protocol to be proposed for screening and diagnosing GDM.
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Base de dados:
MEDLINE
Assunto principal:
Glicemia
/
Programas de Rastreamento
/
Diabetes Gestacional
/
Teste de Tolerância a Glucose
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Screening_studies
Idioma:
En
Revista:
Sao Paulo Med J
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Brasil