Should We Perform an OGTT in All Latino Pregnant Women? The Negative Predictive Value of a Fasting Blood Glucose

Background: Latino women are considered a high-risk group, prone to develop GDM. Currently, according to the ADA Standard of Care Recommendations, these subjects should undergo screening with an OGTT, which is a time and resource consuming procedure. A better selection of the individual would favor a cost-effective diagnostic approach. Our hypothesis is that we could find a fasting blood glucose threshold able to predict a normal OGTT response. Methods: We analyzed the results of 363 one-step, 75-g OGTT performed in our clinic during 2017. Patients with a previously known glucose tolerance abnormality were excluded from the study. Results: The fasting glucose value was diagnostic of GDM in 83/363 cases. After selecting only those cases with fasting value lower than 92 mg/dL, 22 additional subjects were diagnosed with GDM. The one-hour post-load value criteria was met in 16/280 (5.71%) whilst the 2 hour value diagnosed 6 additional subjects (2.86%). Two patients had both one and two hour positive criteria. The area under the curve was 0.75, for fasting blood glucose as a predictor of an abnormal glucose response. Conclusions: In our population from a Mexican University Hospital, the fasting blood glucose detected fourfold the cases of GDM vs. the OGTT. It might be cost effective to perform a fasting glucose prior to prescribe an OGTT in pregnant subjects. Disclosure L.G. Mancillas-Adame: None. C.D. Gonzalez: None. J.A. Villarreal: None. D. Saldivar-Rodriguez: None. F.J. Lavalle-Gonzalez: None. R. Rodriguez-Gutierrez: None. J.G. Gonzalez-Gonzalez: None.