Fasting Glucose Testing in First Trimester Allows Early Risk Detection

clinicians from Israel report in the September issue of Diabetes Care

Their retrospective analysis centered on 6,129 women with singleton pregnancies who had a first trimester fasting glucose level recorded. 

A median of 9.5 weeks gestation, the median fasting glucose level was 79 mg/dL.

With increasing fasting maternal glucose levels, the frequency of gestational diabetes mellitus development increased from 1.0% in the lowest category to 11.7% in the highest; the frequency of large for gestational age and/or macrosomia increased from 7.9% to 19.4%, and for primary cesarean section it increased from 12.7% to 20.0%.

They also note that there was a "strong, graded association between first-trimester fasting glucose level and abnormal glucose challenge test and fair correlation between first-trimester fasting glucose level and fasting glucose level at the time of oral glucose tolerance test."

Whereas gestational diabetes mellitus screening is usually recommended at the start of the third trimester "in order to maximize the metabolic effects of pregnancy," the current study suggests that early screening may be worthwhile, the investigators note.