Screening For Gestational Diabetes Mellitus: Comparison Of A Glucose Polymer And A Glucose Monomer Test Beverage

Abstract

Background: The current test for gestational diabetes mellitus (GDM) uses a glucose monomer test beverage, which frequently causes gastrointestinal symptoms, and venipuncture. We investigated a simplified test using a beverage of glucose polymer and a capillary whole blood glucose measurement.

Methods: In a randomized, double-blind clinical trial, women at 24 to 28 weeks’ gestation received a 50-g glucose monomer (n = 41) or glucose polymer (n = 35) beverage. Venous and capillary blood samples were obtained 1 hour later. The women then completed standardized questionnaires about their symptoms.

Results: The glucose polymer beverage was associated with significantly fewer symptoms than was the glucose monomer drink: the mean was 1.1 symptoms per test with the glucose monomer drink and 0.4 symptoms per test with the glucose polymer drink (P < 0.05), 51 percent of the women developed symptoms after drinking the glucose monomer beverage, and 27 percent of the women developed symptoms after drinking the glucose polymer beverage (P < 0.05). Glucose type did not affect the 1-hour plasma glucose level, mean 5.94 mmol/L (107 mg/dL) for the glucose monomer and 5.76 mmol/L (103.8 mg/dL) for the glucose polymer (P = 0.79). For the capillary test, sensitivity was 0.75 and specificity was 0.82 in detecting a screening test positive by the venous plasma glucose criterion.

Conclusion: The results of this study indicate that a glucose polymer beverage is better tolerated than a glucose monomer beverage during GDM screening, but capillary glucose measurement might be of limited use in clinics where many personnel perform the capillary blood glucose testing.