Background: The screening strategy in Sweden for GDM is mainly based on random plasma glucose measurements combined with presence of risk factors (previous GDM or LGA (large for gestational age) /macrosomia, obesity, heredity, accelerated growth or polyhydramnios) . The association of risk factors with mean levels of glucose in the diagnostic OGTT in different populations is unclear.
Method/Material: Data from Changing Diagnostic Criteria for GDM in Sweden (CDC4G) - a stepped wedge randomised RCT (ISRCTN41918550) where centers during 2018 were randomized to switch to new IADPSG criteria for GDM every month. All pregnant women underwent a venous OGTT during 2018. Mean glucose values by risk factor are presented with 95% CI, significant p value <0. (marked bold in the table) .
Results: Of 53 124 pregnancies 69 (13.0%) underwent venous OGTT. Either metformin or Insulin was used in 11% before the diagnostic criteria switch and 18.8% after the switch. Metformin only was used in 9.7% before and in 16.4% after randomization to new criteria.
Conclusions: BMI≥35 or Previous LGA/macrosomia were associated with a higher fasting glucose value in OGTT, but previous GDM, accelerated growth and high random blood glucose were statistically significantly associated with higher glucose values in all measurements in the diagnostic OGTT. Women with previous GDM had the highest proportion treated with either insulin and/or metformin
H.E.Fadl: None. H.Strevens: None. U.Wennerholm: None. M.Persson: None. M.De brun: None. S.Montgomery: None. D.Simmons: Other Relationship; Elsevier, Research Support; Abbott, Hitachi, Ltd., Novo Nordisk, Speaker's Bureau; Sanofi. S.Patil: None. A.Wikström: None. S.P.Jansson: None. V.Sengpiel: None. K.Berntorp: None. L.Ryen: None. F.Ahlsson: None. E.S.Lindholm: None.
Swedish Research Council (2018-00470)