Introduction: Early pregnancy hyperglycemia threshold (FPG ≥92mg/dl (≥5.1mmol/l)) suggested by International Association of Diabetes and Pregnancy Study Groups (IADPSG) is debateable. There is no evidence of their glycemic status at 24-28 weeks in Indians.
Aim: To understand the 24-28 weeks glycemic status in women with early pregnancy hyperglycemia.
Methods: STratification of Risk of Diabetes in Early pregnancy (STRiDE) study, designed to identify the role of HbA1c in early pregnancy on incident GDM, recruited 2703 pregnant women from 7 centres in south India and 566 (20.9%) women had early pregnancy hyperglycemia. Of these 477 women underwent 24-28 weeks screening (OGTT n=150, FPG n=327)
Results: Abnormal glucose values were present in 32.7% of women at 24-28 weeks (high FPG or GDM by OGTT). These women had higher weight, BMI, waist circumference, family history of diabetes, FPG, and HbA1c at booking compared to women who were normoglycaemic. In multiple regression analysis, early pregnancy FPG ≥95mg/dl (5.3mmol/l) was independently associated with abnormal glucose values at 24-28 weeks (aOR: 1.9; 95% CI: 1.3-3.0, p <0.001), adjusted for key covariates.
Conclusion: Majority of women who had early pregnancy hyperglycaemia became normoglycaemic at 24-28 weeks. HAPO study FPG threshold for the adverse outcomes with aOR: 2.0 was ≥95mg/dl. It may be prudent to classify Indian women with this threshold in early pregnancy as abnormal.
W.Hannah: None. M.Deepa: None. C.Shivashri: None. H.Saite: None. U.Ram: None. R.Anjana: None. Y.Ghebremichael-weldeselassie: None. P.Saravanan: Other Relationship; Novo Nordisk, Research Support; Novo Nordisk, Amgen Inc., Abbott. V.Mohan: None.
Medical Research Council, UK (MR/N006232/1)