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Selected Publication:
Weiss, PA; Haeusler, M; Tamussino, K; Haas, J.
Can glucose tolerance test predict fetal hyperinsulinism?
BJOG. 2000; 107(12):1480-1485
Doi: 10.1111/j.1471-0528.2000.tb11671.x
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- Co-authors Med Uni Graz
- Haas Josef
- Haeusler Martin
- Tamussino Karl
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- Abstract:
- Objective To establish cut off levels for oral glucose tolerance test in pregnancy using fetal hyperinsulinism as a clinical endpoint.Design Capillary blood glucose levels at 0, 1, and 2 hours after the ingestion of either 1 g/kg or 75 g glucose, at 28 (SD 5) weeks of gestation were analysed in 220 women with elevated amniotic fluid insulin levels [greater than or equal to 42 pmol/L (greater than or equal to 7 muU/mL)] after a mean (SD) of 31 weeks (3) and in 220 nondiabetic controls.Results In women with elevated amniotic fluid insulin levels the mean (SD) capillary blood glucose values at 0, 1, and 2 hours were 5.2 mmol/L (1.0) [94 mg/dL(18)], 105 mmol/L(1.4) [189 mg/dL (25)] and 8.2 mmol/L (2.0) [147 mg/dL (36)], respectively. The one-hour value had the highest sensitivity to predict elevated amniotic fluid insulin levels. The 5th centile of the one-hour blood glucose levels representing a detection rate of 95% was 8.9 mmol/L (160 mg/dL).Conclusion Glucose cut off levels in most established oral glucose tolerance test criteria are too high, to accurately predict amniotic fluid hyperinsulinism. A one-hour test may be sufficient for detecting amniotic fluid hyperinsulinism. Since different loads (1 g/kg, 75 g or 100 g) and blood fractions (venous plasma or capillary blood) have minimal impact on oral glucose tolerance test results, a single one-hour cut off of 8.9 mmol/L (160 mg/dL), independent of the sampling method, may be appropriate for the diagnosis of gestational diabetes mellitus severe enough to cause amniotic fluid hyperinsulinism.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Amniotic Fluid - chemistry
- Blood Glucose - metabolism
- Diabetes, Gestational - diagnosis
- Female -
- Fetal Diseases - diagnosis Fetal Diseases - etiology
- Glucose - administration and dosage
- Glucose Tolerance Test - methods Glucose Tolerance Test - standards
- Humans -
- Hyperinsulinism - diagnosis Hyperinsulinism - etiology
- Insulin - metabolism
- Pregnancy -
- Sensitivity and Specificity -