R I Med J (2013). 2025 Jan 2;108(1):13-18.
ABSTRACT
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.
PMID:39693529
