Development of a fasting blood glucose-based strategy to diagnose women with gestational diabetes mellitus at increased risk of adverse outcomes in a COVID-19 environment
To evaluate the role of fasting blood glucose (FBG) to minimise the use of the oral glucose tolerance test in pregnancy (POGTT) for the diagnosis of gestational diabetes mellitus (GDM). We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30...
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| creator | d'Emden, Michael McLeod, Donald Ungerer, Jacobus Appleton, Charles Kanowski, David |
| description | To evaluate the role of fasting blood glucose (FBG) to minimise the use of the oral glucose tolerance test in pregnancy (POGTT) for the diagnosis of gestational diabetes mellitus (GDM).
We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30 June 2015. A receiver operator characteristics (ROC) assessment was undertaken to indicate the FBG level that most effectively identified women at low risk of an abnormal result.
There were 3,946 (15.0%) patients having GDM with 2,262 (8.6%) having FBG ≥ 5.1mmol/l. The ROC identified FBG levels >4.6mmol/l having the best specificity (77%) and sensitivity (54%) for elevated 1 and/or 2hr BGLs. There were 19,321 (73.7%) women having FBG < 4.7mmol/l with a prevalence of GDM of 4.0%, less than 1/3rd the overall rate. Only 4,638 (17.7%) women having FBGs from 4.7-5.0mmol/l would require further evaluation to confirm or exclude the diagnosis.
This contemporary study of women across the state of Queensland, Australia suggests the FBG can be used effectively to define glucose tolerance in pregnancy, minimising their contact with pathology laboratories and potential exposure to the corona virus. This analysis, used in conjunction with outcome data from the HAPO study, provides reassurance to women and their health professionals that FBG < 4.7mmol/l has both a low rate of abnormal glucose tolerance and minimal adverse pregnancy-associated complications. |
| doi_str_mv | 10.1371/journal.pone.0243192 |
| format | Article |
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We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30 June 2015. A receiver operator characteristics (ROC) assessment was undertaken to indicate the FBG level that most effectively identified women at low risk of an abnormal result.
There were 3,946 (15.0%) patients having GDM with 2,262 (8.6%) having FBG ≥ 5.1mmol/l. The ROC identified FBG levels >4.6mmol/l having the best specificity (77%) and sensitivity (54%) for elevated 1 and/or 2hr BGLs. There were 19,321 (73.7%) women having FBG < 4.7mmol/l with a prevalence of GDM of 4.0%, less than 1/3rd the overall rate. Only 4,638 (17.7%) women having FBGs from 4.7-5.0mmol/l would require further evaluation to confirm or exclude the diagnosis.
This contemporary study of women across the state of Queensland, Australia suggests the FBG can be used effectively to define glucose tolerance in pregnancy, minimising their contact with pathology laboratories and potential exposure to the corona virus. This analysis, used in conjunction with outcome data from the HAPO study, provides reassurance to women and their health professionals that FBG < 4.7mmol/l has both a low rate of abnormal glucose tolerance and minimal adverse pregnancy-associated complications.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0243192</identifier><identifier>PMID: 33270719</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Australia ; Biology and Life Sciences ; Blood ; Blood Glucose - analysis ; Blood Glucose - metabolism ; Blood glucose tests ; Complications ; Control ; Corona ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; Diabetes ; Diabetes mellitus ; Diabetes, Gestational - blood ; Diabetes, Gestational - diagnosis ; Diabetes, Gestational - epidemiology ; Diagnosis ; Disease transmission ; Epidemics ; Evaluation ; Fasting ; Fasting - metabolism ; Female ; Gastrointestinal surgery ; Gestational diabetes ; Glucose ; Glucose tolerance ; Glucose Tolerance Test - methods ; Glucose Tolerance Test - standards ; Health risks ; Hospitals ; Humans ; Laboratory testing ; Medical laboratories ; Medical personnel ; Medicine and Health Sciences ; Methods ; Pathology ; Physical Sciences ; Pregnancy ; Pregnancy complications ; Queensland ; Research design ; Risk factors ; Social distancing ; Software ; Values ; Viruses ; Womens health</subject><ispartof>PloS one, 2020-12, Vol.15 (12), p.e0243192</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 d’Emden et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 d’Emden et al 2020 d’Emden et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-4322b39f071ee1e0fa24ccba83c1111deee38f829d87afd9ab2ea4dd612639d63</citedby><cites>FETCH-LOGICAL-c692t-4322b39f071ee1e0fa24ccba83c1111deee38f829d87afd9ab2ea4dd612639d63</cites><orcidid>0000-0002-0149-639X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714128/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714128/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33270719$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Spradley, Frank T.</contributor><creatorcontrib>d'Emden, Michael</creatorcontrib><creatorcontrib>McLeod, Donald</creatorcontrib><creatorcontrib>Ungerer, Jacobus</creatorcontrib><creatorcontrib>Appleton, Charles</creatorcontrib><creatorcontrib>Kanowski, David</creatorcontrib><title>Development of a fasting blood glucose-based strategy to diagnose women with gestational diabetes mellitus at increased risk of adverse outcomes in a COVID-19 environment</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To evaluate the role of fasting blood glucose (FBG) to minimise the use of the oral glucose tolerance test in pregnancy (POGTT) for the diagnosis of gestational diabetes mellitus (GDM).
We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30 June 2015. A receiver operator characteristics (ROC) assessment was undertaken to indicate the FBG level that most effectively identified women at low risk of an abnormal result.
There were 3,946 (15.0%) patients having GDM with 2,262 (8.6%) having FBG ≥ 5.1mmol/l. The ROC identified FBG levels >4.6mmol/l having the best specificity (77%) and sensitivity (54%) for elevated 1 and/or 2hr BGLs. There were 19,321 (73.7%) women having FBG < 4.7mmol/l with a prevalence of GDM of 4.0%, less than 1/3rd the overall rate. Only 4,638 (17.7%) women having FBGs from 4.7-5.0mmol/l would require further evaluation to confirm or exclude the diagnosis.
This contemporary study of women across the state of Queensland, Australia suggests the FBG can be used effectively to define glucose tolerance in pregnancy, minimising their contact with pathology laboratories and potential exposure to the corona virus. This analysis, used in conjunction with outcome data from the HAPO study, provides reassurance to women and their health professionals that FBG < 4.7mmol/l has both a low rate of abnormal glucose tolerance and minimal adverse pregnancy-associated complications.</description><subject>Adult</subject><subject>Australia</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Blood Glucose - analysis</subject><subject>Blood Glucose - metabolism</subject><subject>Blood glucose tests</subject><subject>Complications</subject><subject>Control</subject><subject>Corona</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes, Gestational - blood</subject><subject>Diabetes, Gestational - diagnosis</subject><subject>Diabetes, Gestational - epidemiology</subject><subject>Diagnosis</subject><subject>Disease transmission</subject><subject>Epidemics</subject><subject>Evaluation</subject><subject>Fasting</subject><subject>Fasting - metabolism</subject><subject>Female</subject><subject>Gastrointestinal surgery</subject><subject>Gestational diabetes</subject><subject>Glucose</subject><subject>Glucose tolerance</subject><subject>Glucose Tolerance Test - methods</subject><subject>Glucose Tolerance Test - standards</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laboratory testing</subject><subject>Medical laboratories</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Pathology</subject><subject>Physical Sciences</subject><subject>Pregnancy</subject><subject>Pregnancy complications</subject><subject>Queensland</subject><subject>Research design</subject><subject>Risk factors</subject><subject>Social distancing</subject><subject>Software</subject><subject>Values</subject><subject>Viruses</subject><subject>Womens health</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1tv0zAUxyMEYmPwDRBYQkLw0BLbqR2_IE0dl0qTKnHZq-XYJ6lLGne207GvxKfEabupRXvAeXDk8zv_c7FPlr3E-RhTjj8sXe871Y7XroNxTgqKBXmUnWJByYiRnD4--D_JnoWwzPMJLRl7mp1QSnjOsTjN_lzABlq3XkEXkauRQrUK0XYNqlrnDGraXrsAo0oFMChEryI0tyg6ZKxqumRCNy45oxsbF6iBEFW0LuU12CuIENAK2tbGPiAVke20h62Ut-HXNqDZgE8qro86CYWEpCSm86vZxQgLBN3GetcN6T3PntSqDfBiv59lPz9_-jH9Orqcf5lNzy9HmgkSRwUlpKKiTvUBYMhrRQqtK1VSjdMyAEDLuiTClFzVRqiKgCqMYZgwKgyjZ9nrne66dUHu2xwkKRjjjAtBEzHbEcappVx7u1L-Vjpl5fbA-UYqH61uQWLMeTGZaC1YXhDBlSh4wWqiDS3NhJdJ6-M-Wl-twOhUqFftkeixpbML2biN5BwXmAwC7_YC3l336QLkygadeq46cP02b85wmUpP6Jt_0Ier21ONSgXYrnYprh5E5TkrKOOU5EPY8QNU-gysrE5vsrbp_Mjh_ZFDYiL8jo3qQ5Cz79_-n51fHbNvD9gFqDYugmv74RmGY7DYgdq7EDzU903GuRxG6q4bchgpuR-p5Pbq8ILune5miP4FYykeKQ</recordid><startdate>20201203</startdate><enddate>20201203</enddate><creator>d'Emden, Michael</creator><creator>McLeod, Donald</creator><creator>Ungerer, Jacobus</creator><creator>Appleton, Charles</creator><creator>Kanowski, David</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>COVID</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0149-639X</orcidid></search><sort><creationdate>20201203</creationdate><title>Development of a fasting blood glucose-based strategy to diagnose women with gestational diabetes mellitus at increased risk of adverse outcomes in a COVID-19 environment</title><author>d'Emden, Michael ; McLeod, Donald ; Ungerer, Jacobus ; Appleton, Charles ; Kanowski, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-4322b39f071ee1e0fa24ccba83c1111deee38f829d87afd9ab2ea4dd612639d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Australia</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Blood Glucose - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>d'Emden, Michael</au><au>McLeod, Donald</au><au>Ungerer, Jacobus</au><au>Appleton, Charles</au><au>Kanowski, David</au><au>Spradley, Frank T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a fasting blood glucose-based strategy to diagnose women with gestational diabetes mellitus at increased risk of adverse outcomes in a COVID-19 environment</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-12-03</date><risdate>2020</risdate><volume>15</volume><issue>12</issue><spage>e0243192</spage><pages>e0243192-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To evaluate the role of fasting blood glucose (FBG) to minimise the use of the oral glucose tolerance test in pregnancy (POGTT) for the diagnosis of gestational diabetes mellitus (GDM).
We analysed the POGTTs of 26,242 pregnant women in Queensland, Australia, performed between 1 January 2015 and 30 June 2015. A receiver operator characteristics (ROC) assessment was undertaken to indicate the FBG level that most effectively identified women at low risk of an abnormal result.
There were 3,946 (15.0%) patients having GDM with 2,262 (8.6%) having FBG ≥ 5.1mmol/l. The ROC identified FBG levels >4.6mmol/l having the best specificity (77%) and sensitivity (54%) for elevated 1 and/or 2hr BGLs. There were 19,321 (73.7%) women having FBG < 4.7mmol/l with a prevalence of GDM of 4.0%, less than 1/3rd the overall rate. Only 4,638 (17.7%) women having FBGs from 4.7-5.0mmol/l would require further evaluation to confirm or exclude the diagnosis.
This contemporary study of women across the state of Queensland, Australia suggests the FBG can be used effectively to define glucose tolerance in pregnancy, minimising their contact with pathology laboratories and potential exposure to the corona virus. This analysis, used in conjunction with outcome data from the HAPO study, provides reassurance to women and their health professionals that FBG < 4.7mmol/l has both a low rate of abnormal glucose tolerance and minimal adverse pregnancy-associated complications.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33270719</pmid><doi>10.1371/journal.pone.0243192</doi><tpages>e0243192</tpages><orcidid>https://orcid.org/0000-0002-0149-639X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Australia Biology and Life Sciences Blood Blood Glucose - analysis Blood Glucose - metabolism Blood glucose tests Complications Control Corona Coronaviruses COVID-19 COVID-19 - epidemiology Diabetes Diabetes mellitus Diabetes, Gestational - blood Diabetes, Gestational - diagnosis Diabetes, Gestational - epidemiology Diagnosis Disease transmission Epidemics Evaluation Fasting Fasting - metabolism Female Gastrointestinal surgery Gestational diabetes Glucose Glucose tolerance Glucose Tolerance Test - methods Glucose Tolerance Test - standards Health risks Hospitals Humans Laboratory testing Medical laboratories Medical personnel Medicine and Health Sciences Methods Pathology Physical Sciences Pregnancy Pregnancy complications Queensland Research design Risk factors Social distancing Software Values Viruses Womens health |
| title | Development of a fasting blood glucose-based strategy to diagnose women with gestational diabetes mellitus at increased risk of adverse outcomes in a COVID-19 environment |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T05%3A06%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Development%20of%20a%20fasting%20blood%20glucose-based%20strategy%20to%20diagnose%20women%20with%20gestational%20diabetes%20mellitus%20at%20increased%20risk%20of%20adverse%20outcomes%20in%20a%20COVID-19%20environment&rft.jtitle=PloS%20one&rft.au=d'Emden,%20Michael&rft.date=2020-12-03&rft.volume=15&rft.issue=12&rft.spage=e0243192&rft.pages=e0243192-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0243192&rft_dat=%3Cgale_plos_%3EA643673208%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2466767993&rft_id=info:pmid/33270719&rft_galeid=A643673208&rft_doaj_id=oai_doaj_org_article_1177455cc9604297a94746f2cd38d578&rfr_iscdi=true |