Selective screening strategies for gestational diabetes : a prospective cohort observational study

Show simple item record Adam, Sumaiya Rheeder, Paul 2017-11-24T07:57:52Z 2017-11-24T07:57:52Z 2017-10-22
dc.description.abstract AIM. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. METHODS. We conducted a cohort study on nondiabetic women < 26 weeks gestation at a level 1 clinic in Johannesburg, South Africa. At recruitment, participants completed a questionnaire and random basal glucose and HbA1c were evaluated. A 75 g 2-hour OGTT was scheduled between 24–28 weeks gestation, as per FIGO guidelines. A score was derived using multivariate logistic regression. Published scoring systems were tested by deriving ROC curves. RESULTS. In 554 women, RBG, BMI, and previous baby ≥ 4000 g were significant risk factors included for GDM, which were used to derive a nomogram-based score. The logistic regression model for prediction of GDM had R2 0.143, Somer’s Dxy rank correlation 0.407, and Harrell’s c-score 0.703. HbA1c did not improve predictive value of the nomogram at any threshold (e.g,. at probability > 10%, 25.6% of cases were detected without the HbA1c, and 25.8% of cases would have been detected with the HbA1c). The 9 published scoring systems performed poorly. CONCLUSION. We propose a nomogram-based score that can be used at first antenatal visit to identify women at high risk of GDM. en_ZA
dc.description.department Internal Medicine en_ZA
dc.description.department Obstetrics and Gynaecology en_ZA
dc.description.librarian am2017 en_ZA
dc.description.sponsorship This study was partly supported by funding from the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA), the South African Sugar Association (SASA), and Roche. The SASA and SEMDSA grants were awarded following peer review for scientific quality and priority assessment. en_ZA
dc.description.uri en_ZA
dc.identifier.citation Adam, S & Rheeder, P 2017, 'Selective screening strategies for gestational diabetes : a prospective cohort observational study', Journal of Diabetes Research, vol. 2017, no. 284346, pp. 1-9. en_ZA
dc.identifier.issn 2314-6745 (print)
dc.identifier.issn 2314-6753 (online)
dc.identifier.other 10.1155/2017/2849346
dc.language.iso en en_ZA
dc.publisher Hindawi Publishing en_ZA
dc.rights © 2017 Sumaiya Adam and Paul Rheeder. This is an open access article distributed under the Creative Commons Attribution License. en_ZA
dc.subject Diagnosis en_ZA
dc.subject Women en_ZA
dc.subject Johannesburg, South Africa en_ZA
dc.subject GDM en_ZA
dc.subject Hyperglycemia en_ZA
dc.subject Glucose en_ZA
dc.subject Prevalence en_ZA
dc.subject Mellitus en_ZA
dc.subject Early pregnancy en_ZA
dc.subject African population en_ZA
dc.subject Risk factors en_ZA
dc.title Selective screening strategies for gestational diabetes : a prospective cohort observational study en_ZA
dc.type Article en_ZA

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