First trimester fasting glycaemia ≥ 92 mg/dl and risk of gestational diabetes in the 24-28th week ogtt

Catarina Cidade-Rodrigues; Vania Benido; Catarina Chaves; Bruna Silva; Ana Saavedra; Alexandra Araujo; Claudia Machado; Catarina Pereira; Vania Gomes; Odete Figueiredo; Anabela Melo; Anabela Ferreira; Mariana Martinho; Ana Morgado; Margarida Almeida; Almeida Maria Ceu; Filipe Cunha

doi:10.1530/endoabs.99.P52

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Endocrine Abstracts (2024) 99 P52 | DOI: 10.1530/endoabs.99.P52

ECE2024 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (130 abstracts)

First trimester fasting glycaemia ≥ 92 mg/dl and risk of gestational diabetes in the 24-28th week ogtt

Catarina Cidade-Rodrigues ¹ , Vania Benido ¹ , Catarina Chaves ¹ , Bruna Silva ¹ , Ana Saavedra ¹ , Alexandra Araujo ¹ , Claudia Machado ¹ , Catarina Pereira ¹ , Vania Gomes ¹ , Odete Figueiredo ² , Anabela Melo ² , Anabela Ferreira ² , Mariana Martinho ³ , Ana Morgado ² , Margarida Almeida ¹ , Maria Ceu Almeida ⁴ & Filipe Cunha ¹

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¹Centro Hospitalar do Tamega e Sousa, Endocrinology, Portugal; ²Centro Hospitalar do Tamega e Sousa, Gynecology and Obstetrics, Portugal; ³Centro Hospitalar de Vila Nova de Gaia/Espinho, Endocrinology, Portugal; ⁴Centro Hospitalar Universitário de Coimbra, Gynecology and Obstetrics, Portugal

Introduction: Gestational diabetes (GD) is defined as a glucose intolerance firstly recognized during pregnancy and it is the severity of hyperglycaemia which is relevant to maternal and foetal risks. The American Diabetes Association (ADA) recommends screening before 15 weeks of gestation for women at risk, using standard diagnostic criteria, and defines early abnormal glucose metabolism as fasting glucose 110-125 mg/dl or HbA1c 5.9-6.4%. However, the benefit of treating women with early pregnancy detected GD has not been well established, and one third of untreated women showed normal results when retested at 24-28 weeks.

Objectives: We aimed to study the prevalence of GD diagnosis in the 2nd trimester OGTT in women who had 1st trimester glycaemia (FTG) between 92-125 mg/dl and were not pharmacologically treated.

Materials and Methods: Retrospective study using a convenience sample of women from the Portuguese national GD registry who had a FTG between 92-125 mg/dl and had passed unnoticed until the realization of the 24-28th week OGTT and had received no pharmacological treatment. We excluded women without data on known GD risk factors. The primary endpoint was a positive 24-28th week OGTT according to the WHO diagnostic criteria. Women with GD diagnosis by the OGTT and those without GD criteria were compared. A multivariate logistic regression analysis was used to study predictors of GD by the 24-28th week OGTT: the variables included were FTG and those with known association with GD.

Results: We studied 225 women with a median age of 34 (30-37) years and median BMI of 28.3 (24.2-32.4). Forty-eight (21.3%) women had normal results in the 24-28th week OGTT. Women with abnormal OGTT results were older [34 (31-38), 32 (29-35), P=0.02], and had higher BMI [29.3 (24.4-33.6) kg/m² vs 27.4 (23.1-30.3) kg/m², P=0.05]. There were no differences between groups concerning T2D family history, previous GD, previous miscarriage, presence of chronic hypertension, or FTG levels. Women with GD in the OGTT were more likely to use insulin or metformin for the remainder of the pregnancy. In the multivariate logistic regression analysis, age > 35 years and BMI(per 1 kg/m²) associated with diagnosis of GD on the OGTT with an OR (95% CI) of 2.34 (1.04-5.31), P=0.04, and 1.07 (1.00-1.14), P=0.047, respectively, independently of FTG levels, T2D family history, or previous GD.

Conclusion: More than 20% of women with FTG between 92-125 mg/dl had a normal 24-28th week OGTT. Older age and higher BMI were associated with increased risk of abnormal OGTT.