Browsing by Author "Marais, Colin"
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- ItemComparing the diagnosis of gestational diabetes using the oral glucose tolerance test and a designed breakfast in a randomised, cross-over trial(Stellenbosch : Stellenbosch University, 2017-12) Marais, Colin; Hall, David Raymond; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.ENGLISH ABSTRACT: Objective This study compared a standardised, user-friendly designed breakfast (DB) to the 75g OGTT, comparing venous and capillary glucose values for the diagnosis of gestational diabetes. Methods 6 prospective, randomised, cross-over trial comparing the gold standard OGTT to a designed breakfast glucose profile (DBGP) in the diagnosis of gestational diabetes, was performed from March to December 2015. Fifty-one patients, attending the high-risk antenatal clinic at Tygerberg Hospital, were randomised to OGTT or DBGP at baseline. One week later, before intervention, the alternative test was performed. Fasting and 2-hour, venous and capillary values were measured. Patients qualified for screening on risk factors: previous gestational diabetes, previous unexplained intra-uterine death, previous macrosomic baby, booking BMI >40 kg/m2, age >40 years, affected first degree relative, susceptible family origin (Asiatic), acanthosis nigricans and polycystic ovarian syndrome. Results Fasting and 2-hour capillary glucose values measured during the OGTT correlated significantly with laboratory venous samples (Pearson's 0.74; p <0.001 at both time intervals). The 2-hour capillary glucose values obtained for the DB showed satisfactory correlation to the current gold standard OGTT (Pearson's 0.54; p <0.001). Conclusions The designed breakfast glucose profile provides a user-friendly, sufficiently accurate, promising alternative to diagnose GDM that deserves further investigation.
- ItemScreening for gestational diabetes : examining a breakfast meal test(MedPharm Publications, 2016) Marais, Colin; Van Wyk, L.; Conradie, M.; Hall, D.Objective: This study was performed to analyse the carbohydrate quantity of the non-standardised breakfast meal test consumed as part of a screening test for gestational diabetes. Design: A prospective descriptive design was utilised. Setting: Screening for gestational diabetes was performed in the High-Risk Antenatal Clinic at Tygerberg Academic Hospital, Cape Town, South Africa. Subjects: Fifty pregnant women who met the local selection criteria for diabetes screening. Outcome measures: The contents of the patient-provided breakfast meal tests were evaluated individually for total carbohydrate amount and compared with the 75 grams of carbohydrate provided by the oral glucose tolerance test (OGTT). Results: The median carbohydrate amount was 71 g but the range (55–145 g) was wide. Only seven meals (14%) fell within 10% of the 75 g carbohydrate target. Conclusion: The patient-provided breakfast meal showed wide variation in carbohydrate amount. If a meal test is to be used instead of the formal OGTT a carefully measured, prepared, palatable, readily available product would need to be sourced and provided.