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Background: Although the Oral Glucose Tolerance Test (OGTT) is routinely recommended during pregnancy, the number of people who have the test is decreasing. Failure to perform the OGTT poses a risk for both mother and baby health. Objective: This study was conducted to investigate the effects of the education given on the Oral Glucose Tolerance Test in the first antenatal follow-up of pregnant women on having the test. Methodology: In this study, 385 pregnant women (192 in the control group and 193 in the education group) were included. The present study was designed as a quasi-experimental study. The education group was provided with comprehensive education on the oral glucose tolerance test by the researcher after the questionnaire and then an education brochure on the oral glucose tolerance test. The pregnant women in both groups were contacted by phone between the 30th and 37th weeks of pregnancy and were asked whether they had the test or not. In data analysis, descriptive statistics, Chi-square independence test and Binary regression analysis were conducted. Results: Before the education, most pregnant women in both groups would not have OGTT in their current pregnancy (p>0.05). In the second interview after the education, 79.3% of the participants in the education group had oral glucose tolerance test, whereas only 38.5% of the participants in the control group had oral glucose tolerance test (p<0.05). The binary regression analysis results showed that the rate of having oral glucose tolerance test was higher in those with high school and university education (p<0.05). Conclusion: The findings indicated that the education provided using written, verbal, and visual methods based on scientific evidence in the first antenatal follow-ups increased the rate of having oral glucose tolerance test during pregnancy. [ABSTRACT FROM AUTHOR]

Background: The adoption of the International Association of Diabetes Study Groups (IADPSG) criteria for gestational diabetes mellitus (GDM) in Australia has been controversial. Obesity in pregnancy is also a growing concern. Aims: To assess the impact of IADPSG criteria on the incidence of GDM and pregnancy outcomes, and to compare this to the effect of obesity, particularly among women who would not have GDM by the Australasian Diabetes in Pregnancy Society 1998 criteria (ADIPS1998). Material and Methods: A retrospective observational cohort study linking results of 75 g glucose tolerance tests with demographic and pregnancy data was conducted. Results: In our cohort of 6175 pregnancies, GDM was present in 926 (15%) women by the ADIPS1998 criteria; it increased to 1098 (17.8%) women by the IADPSG criteria. Among the 5248 pregnancies which did not meet the ADIPS1998 criteria and were not treated for GDM, women with IADPSG GDM had increased risk of gestational hypertension, pre‐eclampsia, induction of labour (IOL), primary caesarean section (PCS) and large for gestational age (LGA) compared to women without GDM (all P < 0.05), whereas obese women had increased risk of gestational hypertension, pre‐eclampsia, IOL, PCS, small for gestational age (SGA) and shoulder dystocia compared to women of normal weight (all P < 0.05). On multivariate analysis, IADPSG GDM was an independent risk factor only for IOL (P = 0.04) and LGA (<0.001). Obesity was an independent risk factor for gestational hypertension, pre‐eclampsia, IOL, PCS, shoulder dystocia and SGA (all P < 0.001). Conclusions: Within our population, of women who are not currently treated for GDM, obesity is associated with greater pregnancy risk than GDM diagnosed by IADPSG criteria. [ABSTRACT FROM AUTHOR]

We examined whether pregnant women with a normal glucose tolerance test ( OGTT) by New Zealand ( NZ) criteria, but elevated Hb A1c are a clinically important group with gestational diabetes ( GDM). Eighty women with a normal OGTT and HbA1c > 40 mmol/mol, compared with others with GDM, had a significantly higher BMI and were more likely Pacific. Pharmacotherapy was prescribed in 77.5%. Post-partum OGTT and Hb A1c were abnormal in 9/43(20.9%) and 27/42(64.3%), respectively. In 1090 women being screened for GDM by OGTT, most women with GDM had an Hb A1c ≤ 40 mmol/mol. In the 22.1% of women with an Hb A1c > 40 mmol/mol, the OGTT was normal in 61.8%. For centres using Hb A1c to screen for underlying prediabetes/diabetes, these data show that a result >40 mmol/mol identifies women who are likely to require pharmacotherapy. An OGTT is still recommended to diagnose GDM, but these data raise questions about a possible role for Hb A1c in high risk women with a nondiagnostic OGTT. [ABSTRACT FROM AUTHOR]

Background Metformin is increasingly accepted as an alternative to insulin therapy in gestational diabetes mellitus ( GDM). The Metformin in Gestational Diabetes (MiG) trial reported similar pregnancy outcomes for metformin versus insulin; however, supplemental insulin was required in 46% of women on metformin. Aims We aimed to identify predictors of response to metformin monotherapy in women with GDM attending a general hospital antenatal clinic. Methods We offered extended-release metformin to women diagnosed with GDM ( ADIPS 1998 criteria) at ≥24 weeks of gestation. If glucose targets were not achieved (≤5.0 mmol/L fasting, ≤6.7 mmol/L two-h post-meal), women were changed to insulin. We carried out an audit to determine characteristics of metformin responders versus nonresponders. Results Twenty-five women chose initial metformin therapy; 16 (64%) achieved satisfactory glycaemic control (responders). Nine women (36%) were changed to insulin: seven due to inadequate control (nonresponders) and two had metformin intolerance. Fasting glucose at oral glucose tolerance test ( OGTT) was significantly lower in metformin responders versus nonresponders; two-h glucose and BMI did not differ. Ninety-three percent of women with fasting glucose ≤5.2 mmol/L responded to metformin: conversely, at fasting glucose >5.2 mmol/L, 33% responded ( P = 0.005). Neonatal outcomes were similar in metformin responders and nonresponders, women who chose initial insulin therapy ( n = 25), or were diet-controlled ( n = 21). Conclusions In women with GDM, fasting glucose on OGTT predicted response to metformin: at fasting glucose ≤5.2 mmol/L, the probability of response was 93%. Antenatal clinics should determine locally relevant predictors of response to metformin in women with GDM. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare different body mass index (BMI) categories in individuals with diabetes, prediabetes and normal glucose tolerance among the first degree relatives of type 2 diabetic patients. Materials and Methods: A cross-sectional study was conducted during 2005-2007 in Isfahan, Iran. It evaluated 3323 first-degree relatives of diabetic patients selected by consecutive convenient sampling method. Participants were classified as diabetic, prediabetic, and normal glucose tolerance test groups according to the results of 75 g oral glucose tolerance test (OGTT). The analysis of variance (ANOVA) was used for comparison of quantitative variables, and chi square test for comparison of categorical parameters. Results: The study population consisted of 3323 individuals including 306 diabetics (98 males and 208 females), 1309 prediabetics (337 males and 972 females), and 1708 normal subjects (430 males and 1278 females). Among diabetic patients, the prevalence of obesity was 48.5% in women and 27.6% in men. Among prediabetics, the corresponding figures were 45.6% and 27.3%, respectively. Conclusions: Our findings suggest that men are diagnosed with T2DM at lower BMI than women. Moreover, the alarming high prevalence of overweight and obesity among females necessitates preventing and controlling this underlying problem among females. [ABSTRACT FROM AUTHOR]