Association of first trimester fasting plasma glucose and gestational diabetes mellitus: A systematic review and meta-analysis
Keywords:Gestational Diabetes mellitus, Fasting Plasma Glucose, First trimester, Pregnancy, Prevention of GDM
International guidelines have addressed that identifying women at higher risk of GDM early in pregnancy is important as medical nutrition therapy as early as 15th weeks of gestation has a positive impact in preventing the complications. Studies revealed that performing fasting plasma glucose (FPG) as a screening test is an ideal indicator to identify pregnant women at risk of Gestational Diabetes Mellitus (GDM) has a good efficacy, especially at low threshold, easy to measure, inexpensive and reproducible. Our main objective of this study is to systematically evaluate the available literatures on the association of First trimester FPG and GDM. A systematic search on MEDLINE database was carried out with MESH terms “Plasma Glucose” AND “First trimester” AND “Gestational Diabetes”. The study is conducted following the PRISMA checklist. On MEDLINE database search, 190 articles were identified. Out of these 13 were not in English language, 168 were excluded with reasons such as 11 reviews, 143 were not relevant to our study and 14 didn’t have sufficient data. Finally 9 studies were included in the meta-analysis. As there is a physiological drop in the FPG in early pregnancy, in conclusion this study reveals that First trimester FPG of 82-89 mg/dl (<92mg/dl) is statistically significant in predicting the risk of later development of GDM in pregnant women. Due to the limited study data availability in India, further multi-centric prospective research is needed to generalize and validate the results.
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