FPG, GDM diagnosis and fetal outcome
Research type
Research Study
Full title
An exploration of the relationship between fasting plasma glucose, gestational diabetes diagnosis and perinatal outcome
IRAS ID
285954
Contact name
Tomasina Stacey
Contact email
Sponsor organisation
Calderdale and Huddersfield NHS Trust
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
Research Summary
The NICE criteria for diagnosis of GDM in at risk women use a fasting plasma glucose (FPG) of >=5.6mmol and 2-hour post 75g of oral glucose solution result of >7.8mmol. The International Association of Diabetes and Pregnancy Study groups recommend more stringent levels for FPG, using a fasting glucose of >5.1. There is little evidence to suggest the ‘best’ indices to use. A recent study showed that there is a positive relationship between raised FPG and stillbirth rate in untreated women, however when those women undergo treatment for GDM the risk reduces.By recommending a lower FPG rate for diagnosis of GDM, adverse outcomes including stillbirth could be reduced.
The aim of this study is to explore the relationship between fasting plasma glucose, gestational diabetes diagnosis and perinatal outcomes including large for gestational age, mode of delivery and poor birth outcome. We intend to do this by examining 3 years of data at one Trust in the North of England (which has an annual birth rate of over 5,000). We will look at all women who had a Glucose Tolerance test (GTT) in pregnancy (over 30% of women) and gave birth between 2017-2019. We will look to see if there is a relationship between the FPG result, diagnosis of diabetes and the baby's birthweight centile and other birth outcomes, such as mode of birth and shoulder dystocia. These data are collected routinely at this Trust and so it will not require any additional data collection.Summary of Results
Raised fasting plasma glucose (FPG) is associated with an increased risk or adverse perinatal outcome, specifically large for gestational age. Diagnosis of Gestational diabetes reduces this risk. Women who have mildly raised FPG and who would have been diagnosed with GDM in many other countries, but do not meet the NICE guidance threshold have the worst outcomes.REC name
London - Stanmore Research Ethics Committee
REC reference
20/PR/0152
Date of REC Opinion
16 Jul 2020
REC opinion
Favourable Opinion