FASTING BLOOD SUGAR (FBS) IN THE FIRST TRIMESTER: PREDICTIVE VALUE FOR GESTATIONAL DIABETES MELLITUS AND IMPACT ON PREGNANCY-RELATED OUTCOMES

Authors

  • B MARYAM Department of Obstetrics and_Gynaecology, Jinnah Postgraduate Medical Center karachi (JPMC), Pakistan
  • H YASMEEN Department of Obstetrics and_Gynaecology, Jinnah Postgraduate Medical Center karachi (JPMC), Pakistan
  • A MANAF Medical Officer, Sandeman Provincial Hospital Quetta, Pakistan
  • M ASIF Department of cardiology Armed Forces Institute of Cardiology Rawalpindi, Pakistan
  • F ALAM Department of Obstetrics and Gynaecology, Bolan Medical Complex Hospital Quetta, Pakistan
  • S ALAM Department of Pediatric Medicine, Sandeman Provincial Hospital Quetta, Pakistan
  • A SOHAIL Department of Medicine, King Edward Medical University Lahore, Pakistan
  • Z HUSSAIN Department of cardiology National Institute of Cardiovascular Diseases Karachi, Pakistan
  • M KHAN Department of cardiology Armed Forces Institute of Cardiology Rawalpindi, Pakistan
  • A MUSTAFA Bolan University of Medical & Health Sciences Quetta, Pakistan
  • I AHMED Department of Cardiology, Armed Forces Institute of Cardiology Rawalpindi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1179

Keywords:

Gestational Diabetes Mellitus (GDM), Fasting Blood Sugar (FBS), First Trimester, Pregnancy, Maternal Outcomes, Neonatal Outcomes

Abstract

Gestational diabetes mellitus (GDM) is a significant health concern in pregnancy, affecting maternal and neonatal outcomes. Early detection of GDM through fasting blood glucose (FBS) screening may help in timely management to prevent complications. Objective: To determine the fasting blood glucose threshold that accurately predicts the onset of gestational diabetes mellitus (GDM) and its impact on pregnancy outcomes. Methods: A prospective cohort study was conducted at the Obstetrics and Gynecology Department of Jinnah Postgraduate Medical Centre (JPMC), Karachi, from August 2023 to May 2024, involving 405 pregnant women selected through systematic random sampling. Inclusion criteria included singleton pregnancies, excluding women with pregestational diabetes or baseline fasting glucose levels of 126 mg/dL or higher. Baseline data on age, BMI, gestational age, and family history of diabetes were collected, and FBS levels were measured at the initial visit. Oral Glucose Tolerance Tests (OGTT) were conducted between 24 to 28 weeks of gestation to diagnose GDM. Maternal and fetal outcomes were monitored until delivery. Statistical analyses, including logistic regression and ROC curve analysis, were performed using IBM SPSS version 20. Results: Among the 405 participants, with a mean age of 28 ±6.49 years, the mean fasting blood sugar (FBS) was 89.5 mg/dL (±12.3). Impaired FBS (≥92 mg/dL) was noted in 24.70% of participants, and 18.27% were diagnosed with GDM following OGTT. A fasting glucose level of 127.4 mg/dL (±22.1) was observed among women diagnosed with GDM. Logistic regression showed a significant association between FBS ≥92 mg/dL and GDM risk (OR 1.08, CI 1.02-1.14, p=0.011). ROC analysis revealed an FBS cutoff of 92 mg/dL with 73% sensitivity and 68% specificity for predicting GDM. Gestational hypertension was observed in 8.64% of participants, and preeclampsia in 6.67%. Vaginal deliveries occurred in 72.1% of cases, while 27.9% required cesarean sections. Neonatal outcomes showed an 11% macrosomia rate, with 12% requiring NICU admission. Conclusion: Fasting blood glucose levels ≥92 mg/dL in early pregnancy are strongly predictive of gestational diabetes mellitus (GDM). Early FBS screening allows for timely intervention, potentially improving maternal and neonatal outcomes. This study underscores the importance of incorporating FBS screening in routine antenatal care for better pregnancy management.

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References

Nakshine VS, Jogdand SD. A Comprehensive Review of Gestational Diabetes Mellitus: Impacts on Maternal Health, Fetal Development, Childhood Outcomes, and Long-Term Treatment Strategies. Cureus. 2023 Oct 23;15(10):e47500. doi: 10.7759/cureus.47500. PMID: 38021940; PMCID: PMC10663705.

Ray GW, Zeng Q, Kusi P, Zhang H, Shao T, Yang T, et al. Genetic and inflammatory factors underlying gestational diabetes mellitus: a review. 2024;15.

Li KT, Naik S, Alexander M, Mathad JS. Screening and diagnosis of gestational diabetes in India: a systematic review and meta-analysis. Acta Diabetol. 2018 Jun;55(6):613-625. doi: 10.1007/s00592-018-1131-1. Epub 2018 Mar 26. PMID: 29582160; PMCID: PMC5999405.

Rani PR, Begum J. Screening and Diagnosis of Gestational Diabetes Mellitus, Where Do We Stand. J Clin Diagn Res. 2016 Apr;10(4):QE01-4. doi: 10.7860/JCDR/2016/17588.7689. Epub 2016 Apr 1. PMID: 27190902; PMCID: PMC4866200.

International Association of Diabetes and Pregnancy Study Groups Consensus Panel; Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, Dyer AR, Leiva Ad, Hod M, Kitzmiler JL, Lowe LP, McIntyre HD, Oats JJ, Omori Y, Schmidt MI. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010 Mar;33(3):676-82. doi: 10.2337/dc09-1848. PMID: 20190296; PMCID: PMC2827530.

World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. WHO/NMH/MND/13.2. Geneva: WHO; 2013. http://apps.who.int/iris/bitstream/10665/85975/1/WHO_NMH MND_13.2_eng.pdf

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014;37(Suppl. 1):S81–S90

Adnan M, Aasim M. Prevalence of gestational diabetes mellitus in Pakistan: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2024 Feb 3;24(1):108. doi: 10.1186/s12884-024-06290-9. PMID: 38310244; PMCID: PMC10837918.

Al Subhi SK, Al Kindi RM, Al Rawahi A, Al Seyabi IS, Al Mukhaini A. Prevalence of Gestational Diabetes Mellitus Using the Latest World Health Organization Diagnostic Criteria among Omani Women in Muscat, Oman. Oman Med J. 2021 Jan 10;36(1):e215. doi: 10.5001/omj.2021.08. PMID: 33437538; PMCID: PMC7797029.

Mantri, N., Goel, A.D., Patel, M. et al. National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis. BMC Public Health 24, 527 (2024). https://doi.org/10.1186/s12889-024-18024-9

Riskin-Mashiah S, Damti A, Younes G, Auslender R. First trimester fasting hyperglycemia as a predictor for the development of gestational diabetes mellitus. Eur J Obstet Gynecol Reprod Biol. 2010;152:163-167. doi: 10.1016/j. ejogrb.2010.05.036

Hao M, Lin L. Fasting plasma glucose and body mass index during the first trimester of pregnancy as predictors of gestational diabetes mellitus in a Chinese population. Endocr J. 2017;64:561-569. doi: 10.1507/endocrj.EJ16-0359

Li P, Lin S, Li L, Cui J, Zhou S, Fan J. First-trimester fasting plasma glucose as a predictor of gestational diabetes mellitus and the association with adverse pregnancy outcomes. Pak J Med Sci. 2019;35(1):95-100. doi: https://doi.org/10.12669/pjms.35.1.216

Aravind, R. S., Maheshwari, L., & Chander, A. (2016). Evaluation of first trimester fasting blood glucose as a predictor of gestational diabetes mellitus. Indian Journal of Obstetrics and Gynecology Research, 4(1), 66–70. http://www.indianjournals.com/ijor.aspx?target=ijor:ijogr&volume=4&issue=1&article=014

Kabala Tshasuma Hénoch, Cham Lubamba Chamy, Nsambi Bulanda Joseph, Mpoy Wembonyama Charles. Early prediction of Gestational Diabetes Mellitus: Evaluation of fasting blood sugar in the first trimester of pregnancy in Likasi in The Democratic Republic of the Congo. Fortune Journal of Health Sciences. 7 (2024): 360-363.

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Published

2024-10-05

How to Cite

MARYAM , B., YASMEEN , H., MANAF , A., ASIF , M., ALAM , F., ALAM , S., SOHAIL , A., HUSSAIN , Z., KHAN , M., MUSTAFA , A., & AHMED , . I. (2024). FASTING BLOOD SUGAR (FBS) IN THE FIRST TRIMESTER: PREDICTIVE VALUE FOR GESTATIONAL DIABETES MELLITUS AND IMPACT ON PREGNANCY-RELATED OUTCOMES. Biological and Clinical Sciences Research Journal, 2024(1), 1179. https://doi.org/10.54112/bcsrj.v2024i1.1179