Abstract

Objective: We aimed to compare the prevalence of gestational diabetes mellitus (GDM) according to one and two-step approaches in pregnant women and contribute to the national literature by determining which approach would be more beneficial for such women.

Methods: Our study included patients aged 15-45 years who were admitted to our hospital during their 24th-28th gestational weeks of pregnancies between January 2012 and December 2021. Participants were classified into five groups according to age: <25, 25-29, 30-34, 35-39, and more than 40 years. The prevalence of GDM in each group was separately calculated according to the results of the tests.

Results: Overall, 22,743 patients were included in the study. Of these, 2217 patients underwent a one-step 75-gram oral glucose tolerance test (OGTT). One hundred six patients could not tolerate the test, and the prevalence of GDM was 29.7% in 2111 patients who completed the test. Conversely, 20,526 patients underwent 50-gram OGTT, and the glucose level of 5761 (28%) patients was ≥140 mg/dL. A 3-hour 100- gram OGTT was performed for 2870 patients whose test results were positive. When the results of 2807 patients who completed the test were evaluated, the prevalence of GDM was found to be 3.1%.

Conclusion: The one-step approach significantly increases the prevalence of GDM compared with the two-step approach, and in the two-step approach, the diagnostic test can be skipped because the patients do not regularly undergo follow-up examinations. The results suggest that the one-step approach is more appropriate in societies that do not regularly attend follow-up visits.