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Updated: Jun 4, 2025
Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test
Published on: November 13, 2016
Neonatal Outcomes Among Patients Undergoing Intravenous Glucose Tolerance Testing for Screening of Gestational
Jia Jennifer Ding1, Erika F Werner2, Nina K Ayala3
1Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT.
Insights
The intravenous glucose tolerance test (IV GTT) is a viable alternative for screening gestational diabetes (GDM) in patients unable to complete the oral glucose tolerance test (OGTT). Abnormal IV GTT results correlate with increased risks of large for gestational age neonates.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Endocrinology
Background:
- Gestational diabetes (GDM) presents significant maternal and neonatal risks.
- No established alternative exists for patients intolerant to the oral glucose tolerance test (OGTT).
Purpose of the Study:
- To evaluate neonatal outcomes using the intravenous glucose tolerance test (IV GTT) for GDM screening in OGTT-intolerant individuals.
Main Methods:
- A prospective cohort study enrolled 115 patients intolerant to OGTT from February 2019 to February 2020.
- Participants underwent an IV GTT with glucose monitoring based on trimester-specific cut-offs.
- Sample size was calculated to detect a 25% difference in large for gestational age (LGA) neonates.
Main Results:
- 13.0% of participants had abnormal IV GTT results, more frequent in twin gestations.
- Maternal outcomes were comparable between normal and abnormal IV GTT groups.
- Abnormal IV GTT was linked to higher rates of LGA neonates (23.1% vs. 3.1%) and lower neonatal blood glucose nadirs.
Conclusions:
- Abnormal IV GTT results indicate significant neonatal morbidities associated with GDM.
- IV GTT serves as a practical alternative for GDM screening when OGTT is not feasible, particularly for assessing neonatal complications.
Background:
Despite the prevalence and associated maternal and neonatal morbidities of gestational diabetes (GDM), there is no consensus regarding an alternative test for patients who cannot tolerate the oral glucose tolerance test (OGTT).
Objective(S):
To assess neonatal outcomes among patients undergoing an intravenous glucose tolerance test (IV GTT) to screen for GDM when an OGTT could not be tolerated.
Study Design:
Prospective cohort study which enrolled patients intolerant of OGTT between February 2019 to February 2020. All participants underwent an IV GTT and glucose monitoring was initiated if the glucose metabolism rate was abnormal based on trimester-specific cut-offs. 111 participants were needed to detect a 25% difference in the rate of large for gestational age (LGA) infants between patients with a normal compared to those with an abnormal IV GTT result.
Results:
Of the 115 participants who completed glucose testing, 13 (11.3%) had abnormal results. Patient characteristics were similar between those with normal and abnormal test results, with the exception that abnormal results were more common in twin gestation. Maternal outcomes were similar between the two groups. Neonatal complications differed between groups; patients with an abnormal IV GTT result were more likely to have LGA neonates (23.1% vs 3.1%, p=0.02) and lower mean neonatal blood glucose nadirs (36.8 mg/dL vs 48.2 mg/dL, p=0.04).
Conclusion(S):
An abnormal IV GTT result was associated with clinically significant neonatal morbidities commonly associated with GDM. The IV GTT is a reasonable alternative screening test for GDM related neonatal complications when an OGTT cannot be tolerated.
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