Comparing the diagnosis of gestational diabetes using the oral glucose tolerance test and a designed breakfast in a randomised, cross-over trial

Marais, Colin (2017-12)

Thesis (PhD)--Stellenbosch University, 2022.

Thesis

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.

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