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OR: Pregnancy—Clinical/Epidemiology| June 14 2024

202-OR: Prediction of Late Gestational Diabetes Mellitus in Those without Early GDM

DAVID SIMMONS;

DAVID SIMMONS

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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WILLIAM HAGUE;

WILLIAM HAGUE

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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ARIANNE SWEETING;

ARIANNE SWEETING

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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N. WAH CHEUNG;

N. WAH CHEUNG

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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CHRISTOPHER J. NOLAN;

CHRISTOPHER J. NOLAN

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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HELENA TEEDE;

HELENA TEEDE

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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MICHAEL J. PEEK;

MICHAEL J. PEEK

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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ALEXANDRA KAUTZKY-WILLER;

ALEXANDRA KAUTZKY-WILLER

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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EMILY HIBBERT;

EMILY HIBBERT

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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HELENA E. FADL;

HELENA E. FADL

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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VINCENT W.M. WONG;

VINCENT W.M. WONG

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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JÜRGEN HARREITER;

JÜRGEN HARREITER

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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JINCY IMMANUEL;

JINCY IMMANUEL

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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EMILY J. GIANATTI;

EMILY J. GIANATTI

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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VISWANATHAN MOHAN;

VISWANATHAN MOHAN

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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TOBOGM RESEARCH GROUP

TOBOGM RESEARCH GROUP

Campbelltown NSW, Australia, North Adelaide, Australia, SYDNEY, Australia, Woden, Australia, Melbourne, Australia, Canberra, Australia, Vienna, Austria, Kingswood, Australia, Örebro, Sweden, Liverpool, Australia, Campbelltowm, Australia, Palmyra DC, Australia, Chennai, India

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Diabetes 2024;73(Supplement_1):202-OR

https://doi.org/10.2337/db24-202-OR

Aim: To compare glycemic test characteristics for predicting GDM at 24-28 weeks’ gestation (LGDM) among those with a normal OGTT <20 weeks’ gestation.

Methods: Pregnant women with GDM risk factors were enrolled into a multicenter early GDM (EGDM) treatment trial. Women with EGDM are excluded from this analysis. A 2-h 75g OGTT with HbA1c occurred on entry. The OGTT was repeated at 24-28 weeks’ gestation. GDM was defined by WHO 2013 criteria. Receiver Operator Curve (ROC) assessment compared early fasting (FBG), 1-h (1HBG), 2-h (2HBG) glucose and HbA1c prediction of LGDM. ROCs[95%CI] were calculated within European, Asian/Pasifika and other ethnic groups. The proportions with LGDM ≥90^th and <90^th centile, and their odds ratio (OR [95%CI]) using Mantel-Haenszel testing were calculated for each early glycemic test and a composite of any OGTT measure≥90^th centile (F12BG).

Results: Those with LGDM (n=467) vs no GDM (n=2218) were older (31.4±4.9 vs 30.7±5.1 yrs p=0.009), more likely to be overweight/obese (67.0% vs 57.3% p<0.001), non-European (63.6% vs 57.0% p=0.030) and to have a diabetes family history (52.1% vs 40.7% p<0.001). The ROCs for early FBG, 1HBG, 2HBG, HbA1c were 0.63[0.60-0.66], 0.73[0.70-0.76], 0.66[0.63-0.69], 0.63[0.60-0.66] respectively. ROC patterns were similar across ethnic groups. The ≥90^th centile cut-offs (FBG, 1HBG, 2HBG, HbA1c) were ≥4.9 mmol/l, ≥8.8 mmol/l, ≥7.3 mmol/l; ≥5.3% including 11.1%, 10.4%, 10.1%, 15.0% of the cohort. The F12BG composite included 34.0% of the cohort. Comparing ≥90^th centile vs <90^th centile, LGDM was present in 32.6% vs 15.4%, 47.3% vs 13.9%, 36.4% vs 15.3%, 30.1% vs 14.6%, 35.3% vs 11.4% across the 5 measures with OR of 2.6[2.0-3.4], 5.6[4.3-7.2], 3.2[2.4-4.2], 2.5[2.0-3.2], 4.2[3.4-5.2] respectively. Sensitivities were 21.4%, 28.3%, 21.2%, 27.7%, 50.7% respectively.

Conclusions: After excluding those with EGDM, the 1HBG was the best single test, but no single or combined early glycemic measure was sufficiently discriminatory to avoid the second OGTT.

Disclosure

D. Simmons: Speaker's Bureau; Abbott. Consultant; Sanofi. Speaker's Bureau; Ascensia Diabetes Care. Other Relationship; Ascensia Diabetes Care, Boehringer-Ingelheim. Research Support; Dexcom, Inc. Speaker's Bureau; Novo Nordisk. Research Support; Wests Club, NSW, Australia, Roche Diabetes Care. W. Hague: None. A. Sweeting: None. N. Cheung: None. C.J. Nolan: None. H. Teede: None. M.J. Peek: None. A. Kautzky-Willer: None. E. Hibbert: None. H.E. Fadl: None. V.W.M. Wong: None. J. Harreiter: None. J. Immanuel: None. E.J. Gianatti: None. V. Mohan: None.

Funding

National Health and Medical Research Council (grants 1104231 and 2009326), the Region Örebro Research Committee (grants Dnr OLL-970566 and OLL-942177), Medical Scientific Fund of the Mayor of Vienna (project numbers 15205 and 23026), the South Western Sydney Local Health District Academic Unit (grant 2016), and a Western Sydney University Ainsworth Trust Grant (2019).

© 2024 by the American Diabetes Association

2024

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