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One-hour versus two-hour postprandial blood glucose measurement in women with gestational diabetes mellitus: which is more predictive?

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Abstract

The purpose of this study is to investigate postprandial 1-h (PP1) and 2-h (PP2) blood glucose measurements’ correlation with adverse perinatal outcomes. This prospective cohort study consisted of 259 women with gestational diabetes mellitus. During each antenatal visit, HbA1c and fasting plasma glucose (FPG) as well as plasma glucose at PP1 and PP2 were analyzed. There were 144 patients on insulin therapy and 115 patients on diet therapy. A total of 531 blood glucose measurements were obtained at different gestational ages between 24 and 41 gestational weeks. PP2 plasma glucose measurements (but not PP1) were positively correlated with fetal macrosomia. But on adjusted analysis, neither PP1 nor PP2 measurements predicted perinatal complications. In addition to PP1 and PP2, neither FPG nor HbA1c were able to predict perinatal complications or fetal macrosomia when controlled for confounding factors except for a positive correlation between fetal macrosomia and HbA1c in patients on diet therapy. Postprandial 1-h and postprandial 2-h plasma glucose measurements were not superior to each other in predicting fetal macrosomia or perinatal complications. Based on our findings, it can be concluded that both methods may be suitable for follow-up as there are no clear advantages of one measurement over the other.

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References

  1. Group H.S.C.R, B.E. Metzger, L.P. Lowe, A.R. Dyer, E.R. Trimble, U. Chaovarindr, D.R. Coustan, D.R. Hadden, D.R. McCance, M. Hod, H.D. McIntyre, J.J. Oats, B. Persson, M.S. Rogers, D.A. Sacks, Hyperglycemia and adverse pregnancy outcomes. N. Engl. J. Med. 358(19), 1991–2002 (2008). doi:10.1056/NEJMoa0707943

    Article  Google Scholar 

  2. P.M. Catalano, H.D. McIntyre, J.K. Cruickshank, D.R. McCance, A.R. Dyer, B.E. Metzger, L.P. Lowe, E.R. Trimble, D.R. Coustan, D.R. Hadden, B. Persson, M. Hod, J.J. Oats, Group H.S.C.R, The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care 35(4), 780–786 (2012). doi:10.2337/dc11-1790

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. C. Yogev, C. Hod, M. Oats, L. Metzger, D. Dyer, M. Trimble, P. Hadden, Rogers, Hyperglycemia Adverse Pregnancy Outcome Study Cooperative Research G, Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: preeclampsia. Am. J. Obstet. Gynecol. 255(3), e251–e257 (2010). doi:10.1016/j.ajog.2010.01.024

    Google Scholar 

  4. M.V. Rudge, I.M. Calderon, M.D. Ramos, J.F. Abbade, L.M. Rugolo, Perinatal outcome of pregnancies complicated by diabetes and by maternal daily hyperglycemia not related to diabetes. A retrospective 10-year analysis. Gynecol. Obstet. Invest. 50(2), 108–112 (2000)

    Article  CAS  PubMed  Google Scholar 

  5. M. Farren, N. Daly, A.C. O’Higgins, A. McKeating, P.J. Maguire, M.J. Turner, The interplay between maternal obesity and gestational diabetes mellitus. J. Perinat. Med. (2014). doi:10.1515/jpm-2014-0272

    Google Scholar 

  6. G. Bayhan, M. Bahceci, A. Yalinkaya, M. Yayla, A.C. Erden, Diabetes mellitus in pregnancy and perinatal outcome. Gynecol. Obstet. Reprod. Med. 6(2), 99–103 (2000)

    Google Scholar 

  7. J. Pedersen, Weight and length at birth of infants of diabetic mothers. Acta Endocrinol. 16(4), 330–342 (1954)

    CAS  PubMed  Google Scholar 

  8. Committee on Practice B-O, Practice Bulletin No. 137: gestational diabetes mellitus. Obstet. Gynecol. 122(2 Pt 1), 406–416 (2013). doi:10.1097/01.AOG.0000433006.09219.f1

    Google Scholar 

  9. R.G. Moses, E.M. Lucas, S. Knights, Gestational diabetes mellitus. At what time should the postprandial glucose level be monitored? Aust. N. Z. J. Obstet. Gynaecol. 39(4), 457–460 (1999)

    Article  CAS  PubMed  Google Scholar 

  10. B. Weisz, A. Shrim, C.J. Homko, E. Schiff, G.S. Epstein, E. Sivan, One hour versus two hours postprandial glucose measurement in gestational diabetes: a prospective study. J. Perinatol. 25(4), 241–244 (2005). doi:10.1038/sj.jp.7211243

    Article  CAS  PubMed  Google Scholar 

  11. E. Sivan, B. Weisz, C.J. Homko, E.A. Reece, E. Schiff, One or two hours postprandial glucose measurements: are they the same? Am. J. Obstet. Gynecol. 185(3), 604–607 (2001). doi:10.1067/mob.2001.117184

    Article  CAS  PubMed  Google Scholar 

  12. M. de Veciana, C.A. Major, M.A. Morgan, T. Asrat, J.S. Toohey, J.M. Lien, A.T. Evans, Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. N. Engl. J. Med. 333(19), 1237–1241 (1995). doi:10.1056/NEJM199511093331901

    Article  PubMed  Google Scholar 

  13. C.P. Durnwald, L. Mele, C.Y. Spong, S.M. Ramin, M.W. Varner, D.J. Rouse, A. Sciscione, P. Catalano, G. Saade, Y. Sorokin, J.E. Tolosa, B. Casey, G.D. Anderson, Eunice Kennedy Shriver National Institute of Child H, Human Development Maternal-Fetal Medicine Units N, Glycemic characteristics and neonatal outcomes of women treated for mild gestational diabetes. Obstet. Gynecol. 117(4), 819–827 (2011). doi:10.1097/AOG.0b013e31820fc6cf

    Article  PubMed  PubMed Central  Google Scholar 

  14. M.I. Yeral, A.S. Ozgu-Erdinc, D. Uygur, K.D. Seckin, M.F. Karsli, A.N. Danisman, Prediction of gestational diabetes mellitus in the first trimester, comparison of fasting plasma glucose, two-step and one-step methods: a prospective randomized controlled trial. Endocrine (2013). doi:10.1007/s12020-013-0111-z

    PubMed  Google Scholar 

  15. C. Erem, N. Cihanyurdu, O. Deger, C. Karahan, G. Can, M. Telatar, Screening for gestational diabetes mellitus in northeastern Turkey (Trabzon City). Eur. J. Epidemiol. 18(1), 39–43 (2003)

    Article  PubMed  Google Scholar 

  16. World Medical A, World Medical Association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310(20), 2191–2194 (2013). doi:10.1001/jama.2013.281053

    Article  Google Scholar 

  17. M.W. Carpenter, D.R. Coustan, Criteria for screening tests for gestational diabetes. Am. J. Obstet. Gynecol. 144(7), 768–773 (1982)

    Article  CAS  PubMed  Google Scholar 

  18. E. Li, D. Zhang, M. Davidian, Conditional estimation for generalized linear models when covariates are subject-specific parameters in a mixed model for longitudinal measurements. Biometrics 60(1), 1–7 (2004). doi:10.1111/j.0006-341X.2004.00170.x

    Article  PubMed  PubMed Central  Google Scholar 

  19. M.H. Beall, C. Spong, J. McKay, M.G. Ross, Objective definition of shoulder dystocia: a prospective evaluation. Am. J. Obstet. Gynecol. 179(4), 934–937 (1998)

    Article  CAS  PubMed  Google Scholar 

  20. American College of O, Gynecologists, Task Force on Hypertension in P, Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet. Gynecol. 122(5), 1122–1131 (2013). doi:10.1097/01.AOG.0000437382.03963.88

    Article  Google Scholar 

  21. F. Faul, E. Erdfelder, A.G. Lang, A. Buchner, G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods 39(2), 175–191 (2007)

    Article  PubMed  Google Scholar 

  22. American Diabetes A, Standards of medical care in diabetes–2014. Diabetes Care 37(Suppl 1), S14–S80 (2014). doi:10.2337/dc14-S014

    Article  Google Scholar 

  23. A. Ben-Haroush, Y. Yogev, R. Chen, B. Rosenn, M. Hod, O. Langer, The postprandial glucose profile in the diabetic pregnancy. Am. J. Obstet. Gynecol. 191(2), 576–581 (2004). doi:10.1016/j.ajog.2004.01.055

    Article  CAS  PubMed  Google Scholar 

  24. P. Dandona, H.S. Besterman, D.B. Freedman, F. Boag, A.M. Taylor, A.G. Beckett, Macrosomia despite well-controlled diabetic pregnancy. Lancet 1(8379), 737 (1984)

    Article  CAS  PubMed  Google Scholar 

  25. J.C. Hauth, R.G. Clifton, J.M. Roberts, L. Myatt, C.Y. Spong, K.J. Leveno, M.W. Varner, R.J. Wapner, J.M. Thorp Jr, B.M. Mercer, A.M. Peaceman, S.M. Ramin, M.W. Carpenter, P. Samuels, A. Sciscione, J.E. Tolosa, G. Saade, Y. Sorokin, G.D. Anderson, Eunice Kennedy Shriver National Institute of Child H, Human Development Maternal-Fetal Medicine Units N, Maternal insulin resistance and preeclampsia. Am. J. Obstet. Gynecol. 204(4), 327 (2011). doi:10.1016/j.ajog.2011.02.024. e321-326

    Article  PubMed  PubMed Central  Google Scholar 

  26. M.S. Rendell, L. Jovanovic, Targeting postprandial hyperglycemia. Metab. Clin. Exp. 55(9), 1263–1281 (2006). doi:10.1016/j.metabol.2006.05.012

    Article  CAS  PubMed  Google Scholar 

  27. E. Lenters-Westra, R.K. Schindhelm, H.J. Bilo, R.J. Slingerland, Haemoglobin A1c: historical overview and current concepts. Diabetes Res. Clin. Pract. 99(2), 75–84 (2013). doi:10.1016/j.diabres.2012.10.007

    Article  CAS  PubMed  Google Scholar 

  28. S. Lurie, D. Danon, Life span of erythrocytes in late pregnancy. Obstet. Gynecol. 80(1), 123–126 (1992)

    CAS  PubMed  Google Scholar 

  29. J.L. Mills, L. Jovanovic, R. Knopp, J. Aarons, M. Conley, E. Park, Y.J. Lee, L. Holmes, J.L. Simpson, B. Metzger, Physiological reduction in fasting plasma glucose concentration in the first trimester of normal pregnancy: the diabetes in early pregnancy study. Metab. Clin. Exp. 47(9), 1140–1144 (1998)

    Article  CAS  PubMed  Google Scholar 

  30. R.A. Gandhi, J. Brown, A. Simm, R.C. Page, I. Idris, HbA1c during pregnancy: its relationship to meal related glycaemia and neonatal birth weight in patients with diabetes. Eur. J. Obstet. Gynecol. Reprod. Biol. 138(1), 45–48 (2008). doi:10.1016/j.ejogrb.2007.08.011

    Article  CAS  PubMed  Google Scholar 

  31. G.K. Poomalar, Changing trends in management of gestational diabetes mellitus. World J Diabetes 6(2), 284–295 (2015). doi:10.4239/wjd.v6.i2.284

    Article  PubMed  PubMed Central  Google Scholar 

  32. A. Garrison, Screening, diagnosis, and management of gestational diabetes mellitus. Am. Fam. Phys. 91(7), 460–467 (2015)

    Google Scholar 

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Acknowledgements

This paper is selected as a poster presentation in the 13th World Congress in Fetal Medicine, 29 June–3 July 2014 Nice, France.

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Correspondence to A. Seval Ozgu-Erdinc.

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Ozgu-Erdinc, A.S., Iskender, C., Uygur, D. et al. One-hour versus two-hour postprandial blood glucose measurement in women with gestational diabetes mellitus: which is more predictive?. Endocrine 52, 561–570 (2016). https://doi.org/10.1007/s12020-015-0813-5

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