Objective: The status of carbohydrate metabolism of pregnant women with positive glucose challenge test (GCT), but normal oral glucose tolerance test (OGTT); and their neonates have not defined clearly.
Methods: Pregnant women with normal GCT (n: 120), with abnormal glucose challenge test (AGCT) but normal OGTT (n: 67) and those with gestational diabetes (GDM) (n: 67) were included into the study. Local ethical committee approval was obtained. Insulin sensitivity was evaluated by fasting insulin level, homeostasis model assessment of insulin resistance index (HOMA-IR); quantitative insulin check index (QUICKI) and ISOGTT. Serum insulin and glucose values during OGTT were documented. The patients with both AGCT and GDM were treated either with diet or if needed with insulin until achieving the goals for defined glucose values. Perinatal outcome and delivery modalities were also compared between these three groups.
Results: Both GDM (31.6±5.9 yrs) and AGCT groups (29.0±4.0 yrs) were older than control subjects (28.1±4.9 yrs). Body mass index (BMI) was found to increase with a correlation to the severity of carbohydrate intolerance as the predominant factor affecting both AGCT and GDM groups (odds ratios were 3.78 and 5.97 respectively). Despite there was no significance between insulin indices; serum glucose and insulin values were similarly different than controls in both AGCT and GDM groups. Macrosomic infant and caesarean section rates were higher than control group in both GDM and AGCT groups in favor of gestational diabetics (6.6% vs. 18.9%; P=0.0001 and 20% vs. 27.7% P=0.0001 respectively).
Conclusion: Pregnant woman with abnormal glucose challenge test have impaired carbohydrate metabolism as in gestational diabetics with a lesser severe degree.