Development and Evaluation of an Online Questionnaire to Identify Women at High and Low Risk of Developing Gestational Diabetes Mellitus

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2022 Apr 15

PMID 35421942

Authors

Daria Di Filippo

Chloe Bell

Melissa Han Yiin Chang

Justine Darling

Amanda Henry

Alec Welsh

Affiliations

Soon will be listed here.

Abstract

Background: Established risk factors for Gestational Diabetes Mellitus (GDM) include age, ethnicity, family history of diabetes and previous GDM. Additional significant influences have recently been demonstrated in the literature. The oral glucose tolerance test (OGTT) used for GDM diagnosis has sub-optimal sensitivity and specificity, thus often results in GDM misdiagnoses. Comprehensive screening of risk factors may allow more targeted monitoring and more accurate diagnoses, preventing the devastating consequences of untreated or misdiagnosed GDM. We aimed to develop a comprehensive online questionnaire of GDM risk factors and triangulate it with the OGTT and continuous glucose monitoring (CGM) parameters to better evaluate GDM risk and diagnosis.

Methods: Pregnant women participating in two studies on the use of CGM for GDM were invited to complete the online questionnaire. A risk score, based on published literature, was calculated for each participant response and compared with the OGTT result. A total risk score (TRS) was then calculated as a normalised sum of all risk factors. Triangulation of OGTT, TRS and CGM score of variability (CGMSV) was analysed to expand evaluation of OGTT results.

Results: Fifty one women completed the questionnaire; 29 were identified as 'high-risk' for GDM. High-risk ethnic background (p < 0.01), advanced age, a family diabetic history (p < 0.05) were associated with a positive OGTT result. The triangulation analysis (n = 45) revealed six (13%) probable misdiagnoses (both TRS and CGMSV discordant with OGTT), consisting of one probable false positive and five probable false negative by OGTT results.

Conclusions: This study identified pregnant women at high risk of developing GDM based on an extended evaluation of risk factors. Triangulation of TRS, OGTT and CGMSV suggested potential misdiagnoses of the OGTT. Future studies to explore the correlation between TRS, CGMSV and pregnancy outcomes as well as additional GDM pregnancy biomarkers and outcomes to efficiently evaluate OGTT results are needed.

Citing Articles

A new continuous glucose monitor for the diagnosis of gestational diabetes mellitus: a pilot study.

Di Filippo D, Henry A, Bell C, Haynes S, Chang M, Darling J BMC Pregnancy Childbirth. 2023; 23(1):186.

PMID: 36932353 PMC: 10023314. DOI: 10.1186/s12884-023-05496-7.

Oral glucose tolerance test and continuous glucose monitoring for gestational diabetes diagnosis: a survey study of women and health care professionals.

Di Filippo D, Darling J, Chang M, Henry A, Welsh A Arch Gynecol Obstet. 2023; 309(2):483-489.

PMID: 36739593 PMC: 9899442. DOI: 10.1007/s00404-023-06949-2.

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