Clinical Implication of 2nd Trimester Glycosuria

Han, Bo Ryoung; Oh, Youn Seoung; Ahn, Ki Hoon; Kim, Hee Young; Hong, Soon Cheol; Oh, Min Jeong; Kim, Hae Joong; Kim, Young Tae; Lee, Kyu Wan; Kim, Sun Haeng

Abstract

OBJECTIVE
To analyze the incidence of gestational diabetes mellitus (GDM) and its clinical implication of glycosuria identified in 2nd trimester pregnancy.
METHODS
This study included pregnant women who had undertaken the 50 g oral glucose tolerance test (50 g OGTT) between 24 and 28 weeks gestation and delivered at term (N=704). Blood and urine sample were collected and analyzed for glucose level, one hour after 50 g OGTT. We applied women to 100 g OGTT if their blood glucose level after 50 g OGTT were more than 140 mg/dL. We compared blood glucose level, rate of GDM, birth weight and number of macrosomia at different urine glucose levels. Urine glucose level were measured by urine dipstick test and grouped to trace, 1+, 2+, 3+, and 4+, which were corresponding to 100, 250, 500, 1,000, 2,000 mg/dL.
RESULTS
Women with glycosuria after 50 g OGTT were 258/704 (36.6%). Mean blood glucose levels were 117+/-23 mg/dL, 128+/-20 mg/dL, 135+/-23 mg/dL, 132+/-17 mg/dL, 139+/-25 mg/dL, 153+/-45 mg/dL, mean birth weight 3.29+/-0.40 kg, 3.25+/-0.40 kg, 3.27+/-0.41 kg, 3.34+/-0.35 kg, 3.28+/-0.41 kg, 3.33+/-0.40 kg, and numbers of macrosomia (> or =4.0 kg) 20 (4.5%), 3 (4.8%), 1 (1.8%), 2 (4.2%), 3 (6.7%), 0 (0%) at glycosuria level of negative, trace, 1+, 2+, 3+ and 4+ respectively. Glycosuria level was correlated significantly with blood glucose level (P=0.000), but not with birth weight and macrosomia (P=0.838, 0.881). The rate of GDM was 7/55 (12.7%), 2/48 (4.7%), 7/45 (15.6%), 8/48 (16.7%) in glycosuria level of 1+, 2+, 3+, 4+ and their relationship was statistically significant (P=0.000, AUC=0.734, 95%CI 0.638-0.830). In the cut off value of glycosuria 1+ or greater, sensitivity and positive predictive value were 72.7 and 12.2%.
CONCLUSION
Glycosuria correlates well with blood glucose level and GDM prevalence but not with birth weight.