72 Pa Standard Breakfast Validation In Screening Of Gestational Diabetes

Conference: 
Author(s): 

Isabel Fernandez, Centro de Salud de CAMAS, Sevilla - Spain. M Dolores Lopez, Lucia Moron, Ana Rufo, Asuncion Solana, M Angeles Ortiz

Text: 

Introduction:
It is usually recommended the Gestational Diabetes screening in all pregnant women using the O'Sullivan test with a 50 g glucose load. Our aim is to value a standard breakfast in the screening of the Gestational Diabetes.
Methods: We studied 159 pregnant women aged 28 ± 4 years by consecutive sampling in a Primary Health Care Centre. The test was carried out with a standard breakfast (689 Kcal, 100 g carbohydrates, 26 g fat, 15 g proteins and 3 g of fibre) eaten in 15 minutes at 24-28 weeks. The glycaemia is determined at 1/2 hour and at 1 hour after breakfast in capillary blood (Glucocard (R) and in venous plasma at 1 hour (glucose-oxidase method). The gold standard is the OGTT with 100 g of glucose and determinations at 0, 1, 2 and 3 hours. The sensitivity, specificity and predictive values are calculated. The ROC curves are used in order to determine the diagnostic performance of the tests (area under curve) and to calculate the better threshold.
Results:

 

Threshold

Sensitivity

Specificity

AUC

O'Sullivan test - plasma

137

89

72

0.85

30' Breakfast-dipstick

155

56

80

0.61

60' Breakfast-dipstick

132

88

76

0.85

60' Breakfast-plasma

110

100

52

0.88

Conclusion:
The Gestational Diabetes screening test with a standard breakfast presents a performance similar to the O'Sullivan test, being a more physiological test and better tolerated by the pregnant woman. The greatest diagnostic performance is for the determination after 1 hour.
(Project financed by the F.I.S 94/0952 and award by SEMFYC for presentation at the WONCA Congress to be hold in Prague in 1997)

 

Literature: 

72 PA STANDARD BREAKFAST VALIDATION IN SCREENING OF GESTATIONAL DIABETES