ECE2022 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (202 abstracts)
Diagnosis of gestational diabetes mellitus in the COVID-19 pandemic: comparative analysis of women with positive O’Sullivan test in the same trimester of 2019 and 2020
José Ignacio Martínez Montoro 1 , Víctor José Simón Frapolli 1 , María Molina Vega 1 , Sonsoles Morcillo Espina 1,2 , María Suárez Arana 3 , Francisco J. Tinahones 1,2 , María José & Picón César 1
1Hospital Universitario Virgen de la Victoria/Instituto de Investigación Biomédica de Málaga-IBIMA, Endocrinology and Nutrition, Málaga, Spain; 2CIBER Fisiopatología de la Obesidad y Nutrición-CIBEROBN, Spain; 3Hospital Regional Universitario de Málaga, Gynecology and Obstetrics, Málaga, Spain
Introduction: In May 2020, during the COVID-19 pandemic, the Spanish Group of Diabetes and Pregnancy published a consensus document establishing the alternative diagnostic criteria for gestational diabetes mellitus (GDM) in case of impossibility to perform the two-step traditional approach due to the COVID-19 sanitary emergency. This study aims to compare different characteristics of pregnant women who tested positive in the O’Sullivan test in the same pregnancy trimester of 2019 and 2020 – in the latter trimester, alternative diagnostic criteria were applied due to the impracticability to perform the oral glucose tolerance test (OGTT) in our centre –.
Material and methods: Retrospective observational study comparing clinical data of pregnant women who tested positive in the O’Sullivan test in September-October-November 2019 (GDM diagnosis using 100-g OGTT) and 2020 (GDM diagnosis using basal glycaemia/HbA1c). GDM diagnosis was established if basal glycaemia was ≥100 mg/dl (≥5.6 mmol/l) or HbA1c ≥5.9% in the first trimester; and basal glycaemia ≥95 mg/dl (≥5.3 mmol/l) or HbA1c ≥5.7% in the second trimester
Results: Comparative characteristics of both groups are showed in table 1. Notably, in September-October-November 2019 41 women were diagnosed with GDM (16% of women with positive O’Sullivan test) versus 37 in 2020 (13.8%), P=0.489. 10 of the women with GDM were diagnosed before week 24 in 2019 versus 17 in 2020 (15.4% vs 17.7%P=0.699); 31 of the women with GDM were diagnosed after week 24 in 2019 versus 19 in 2020 (16.1% vs 11.1%P=0.165). There were no differences between groups with regard to treatment modality during these comparison periods (P=0.454).
| 2019 Group (n=257) | 2020 Group (n=268) | p | |
| Age (years) | 33,6±6,38 | 33,93±5,01 | 0,535 |
| Previous BMI(kg/m2 ) | 27,87±6,86 | 27,15±6,15 | 0,222 |
| Primiparous | 47.2% | 41.9% | <0,001 |
| Family history of GDM | 24.9% | 30.9% | 0,139 |
| Personal history of GDM | 4.6% | 11.3% | 0,013 |
| History of fetal macrosomia | 2.1% | 10.1% | 0,001 |
| O&unixB4;Sullivan test (mg/dL) | 160±16,7 | 159,41±28,71 | 0,577 |
| Glucose 0&unixB4; (mg/dL) | 84,6±7,88 | 83,69±11,63 | 0,293 |
| Glucose 60&unixB4;(mg/dL) | 160,35±29,81 | ||
| Glucose 120&unixB4;(mg/dL) | 138,8±29,31 | ||
| Glucose 180&unixB4;(mg/dL) | 109,60±31,80 | ||
| HbA1c (%) | 5,23±0,38 | ||
| OGTT gestational age(weeks) | 25,41±6,27 | 23,91±6,97 | 0,010 |
| >24 weeks | 192(74,7%) | 171(63,8%) | 0,008 |
| ≤ 24 weeks | 65(25,3%) | 96(35,8%) | |
| GDM(number) | 41(16%) | 37(13,8%) | 0,489 |
| Treatment | 0,454 | ||
| Insulin | 11(26,8%) | 14(37,8%) | |
| Diet | 29(70,7%) | 21(56,8%) | |
| Metformin | 1(2,4%) | 2(5,4%) |
Conclusion: GDM diagnostic rate was similar using 100-g OGTT criteria (2019) and basal glycaemia/HbA1c criteria due to the COVID-19 pandemic (2020). Besides, there were no differences between periods concerning the number of patients that required pharmacological treatment.
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