Can we detect gestational diabetes in early gestational ages?

Objectives: The objective of this study is determine gestational diabetes mellitus with 50 gr glucose tolerance test during first and second trimester of the pregnancy.Material and Methods: The subjects were 210 pregnant women who came to our hospital. Fifty-gram oral glucose challenge screening was conducted among 210 pregnant women at the time of their first antenatal visit.Women without abnormal results underwent another test at 16-18 and 24-28 weeks? gestation. Patients with gestational diabetes mellitus (GDM) and abnormal glucose tolerance test (AGCT) in early pregnancy were compared with those who had a normal glucose tolerance at the time of this test.Results: Of the 210 subjects, 12 (%5,7) tested positive for GDM and 79 (%86.8) AGCT. Of those 12 patients, four (%33,3) were diagnosed with GDM in the first trimester, six (%50) in the second trimester and two (%16,6) third trimester. This finding suggests the importance of screening for glucose intolerance in the early pregnancy. There were statistical significant differences age, body mass index (BMI) and fasting blood glucose between GDM, AGCT and normal person (p<0.05) at every trimester. There were not any statistical significant differences gravida, parite, abortus and live baby, family history of DM, history of GDM, and history of big baby between GDM, AGCT and normal pregnants (p>0.05)Conclusions: In total 12 women were found to have gestational diabetes mellitus (%5,7). Four had the disorder diagnosed during 11-14. week of pregnancy (%33,3 of women with gestational diabetes and %1.9 of all pregnant women) and the other 8 (%66,6 women with gestational diabetes and %3,8 of all pregnant women) had normal glucose tolerance results during early pregnancy but had diabetes develop second and third trimester.Women with an early diagnosis of gestational diabetes represent a high-risk subgroup. Despite appropriate treatment and care, women with diabetes that was recognized early had a worse prognosis than did those with diabetes diagnosed later, and we suggest that these women represent a subgroup of high risk within the population of women with gestational diabetes. It is likely that early intervention to improve glucose homeostasis avoided some complications commonly related to pregestational diabetes.Further studies are needed to clarify whether early screening should be done among all pregnant women or only among those with high risk of development of diabetes during pregnancy.Key words: Gestational diabetes, pregnancy, first trimester, oral glucose tolerance test