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Are the current ACOG Glucose Tolerance Test criteria sensitive enough?
1Division of Maternal Fetal Medicine, Brown University/Women and Infants' Hospital, Providence, Rhode Island.
One hundred three women with gestational diabetes diagnosed by the criteria used at Women and Infants' Hospital were followed through the prenatal course. Sixty-four also met the current ACOG criteria. Ten of the 39 (26%) who met only the hospital's criteria required insulin therapy, a proportion not different from that in the group who met the ACOG criteria (19 of 64, 30%). The degree of abnormality of the glucose tolerance test (GTT) did not predict subsequent need for insulin treatment. The ACOG GTT criteria may fail to detect a proportion of women with gestational diabetes whose carbohydrate metabolism abnormality is severe enough to require insulin therapy.
One hundred three women with gestational diabetes diagnosed by the criteria used at Women and Infants' Hospital were followed through the prenatal course. Sixty-four also met the current ACOG criteria. Ten of the 39 (26%) who met only the hospital's criteria required insulin therapy, a proportion not different from that in the group who met the ACOG criteria (19 of 64, 30%). The degree of abnormality of the glucose tolerance test (GTT) did not predict subsequent need for insulin treatment. The ACOG GTT criteria may fail to detect a proportion of women with gestational diabetes whose carbohydrate metabolism abnormality is severe enough to require insulin therapy.