ABSTRACT
A pilot study was conducted at the UHWI to evaluate the OGTT as a tool for identifying gestational diabetes in our clinic population. It was performed on 21 high-risk pregnant mothers. When the current WHO criteria for the diagnosis of gestational glucose intolerance were applied, one (1) patient was considered to have gestational diabetes (4.8 per cent), seven (7) patients had impaired glucose tolerance (33.3 per cent), and thirteen (13) were considered normal (61.9 per cent). Insulin levels were determined for 13 of the patients and, within the group of patients with normal OGTT, two distinct groups were identified. Seven of the patients in this group had insulin levels determined, and of these, three had insulin levels similar to that of the impaired glucose tolerance group. Two of these three patients had foetal macrosomia. The remaining four in this group with normal OGTT had normal insulin curves and normal foetal sizes. Six of the patients with impaired glucose tolerance had insulin levels determined and two presented with foetal macrosomia (33 per cent). The results indicate that in spite of screening for impaired carbohydrate metabolism in pregnancy there are still patients who are misdiagnosed by the present WHO criteria using OGTT. Insulin assays may be a more sensitive predictor of altered carbohydrate metabolism (AU)