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Diagnostic ability of elevated 1-h glucose challenge test

Journal of Perinatology volume 36, pages 342–346 (2016)Cite this article

Subjects

Abstract

Objective:

To determine whether a threshold of a 1-h glucose challenge test (GCT) eliminates the need for a 3-h glucose tolerance test (GTT).

Study Design:

A retrospective cohort of patients undergoing GTT after GCT was ⩾140 mg dl−1. Gestational diabetes mellitus (GDM) was diagnosed using National Diabetes Data Group (NDDG) and Carpenter–Coustan (CC) criteria. Sensitivity, specificity and predictive values were calculated for 1-h GCT values of 160 to 220 mg dl−1.

Result:

Of 6218 patients, 988 (15.9%) had an elevated GCT and 753 (12.1%) underwent a GTT. In all, 165 (2.7%) were diagnosed with GDM using NDDG criteria, and 250 (4.0%) by CC criteria. The positive predictive value of a 1-h of GCT ⩾200 mg dl−1 for GDM was 68.6% by NDDG and 80.0% for GDM by CC criteria.

Conclusion:

Although the predictive value of an elevated 1-h ⩽200 mg dl−1 for GDM was high, 1 in 3 to 1 in 5 women would be overdiagnosed with GDM if the 3-h GTT was omitted.

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Acknowledgements

Dr Cahill was a Robert Wood Johnson Foundation Faculty Physician Scholar who partially supported this work. Dr Temming is supported by an NIH T32 training grant (5T32HD055172-07). This publication was also made possible by Grant Number UL1 TR000448 from the NIH National Center for Advancing Translational Sciences (NCATS), components of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCATS or NIH. Presented as Poster #354 at the 36th Annual Meeting of the Society of Maternal and Fetal Medicine, 5 to 7 February 2015, San Diego, CA, USA.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Washington University in St Louis, St Louis, MO, USA

    L A Temming, M G Tuuli, M J Stout, G A Macones & A G Cahill

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  1. L A Temming
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  2. M G Tuuli
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  3. M J Stout
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  4. G A Macones
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  5. A G Cahill
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Correspondence to L A Temming.

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Temming, L., Tuuli, M., Stout, M. et al. Diagnostic ability of elevated 1-h glucose challenge test. J Perinatol 36, 342–346 (2016). https://doi.org/10.1038/jp.2015.215

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