Perinatal and long‐term implications of diagnosing gestational diabetes mellitus using only fasting and one‐hour post‐load glucose concentrations: Secondary analysis of the GEMS trial and its five‐year follow‐up
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2026
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| author | Qiliang Liu Jane E. Harding Greg D. Gamble Carl Eagleton Lisa Dawes Caroline A. Crowther |
| author_facet | Qiliang Liu Jane E. Harding Greg D. Gamble Carl Eagleton Lisa Dawes Caroline A. Crowther Qiliang Liu Jane E. Harding Greg D. Gamble Carl Eagleton Lisa Dawes Caroline A. Crowther |
| collection | Wiley Open Access |
| contents | Perinatal and long‐term implications of diagnosing gestational diabetes mellitus using only fasting and one‐hour post‐load glucose concentrations: Secondary analysis of the GEMS trial and its five‐year follow‐up Qiliang Liu Jane E. Harding Greg D. Gamble Carl Eagleton Lisa Dawes Caroline A. Crowther Acta Obstetricia et Gynecologica Scandinavica Abstract Introduction The proposed revised diagnostic criteria for gestational diabetes (GDM) in New Zealand include a fasting plasma glucose (FPG) concentration ≥5.3 mmol/L and 1‐h post‐load glucose (PLG) concentration ≥10.6 mmol/L on a 75 g oral glucose tolerance test (OGTT), but no 2‐h PLG. This study evaluates the impact of GDM diagnosis based on FPG and/or 1‐h PLG abnormalities on perinatal and long‐term outcomes. Material and Methods This secondary analysis of data from GEMS, a multicentre, randomized trial and its follow‐up, included women and their children who met the proposed revised GDM criteria and received treatment. Participants were classified into three groups: (1) both group: elevated FPG and 1‐h PLG, (2) fasting group: elevated FPG alone, and (3) one‐hour group: elevated 1‐h PLG alone. Between‐group pairwise comparisons were made using log‐binomial and normal‐identity regressions. Results Of 217 eligible women‐child pairs, 85 (39.2%) were in the fasting group, 61 (28.1%) in the both group, and 71 (32.7%) in the one‐hour group. Women in the fasting and both groups, compared with the one‐hour group, were more likely to be overweight or obese both at the first antenatal visit and five‐year follow‐up, more likely to have required pharmacotherapy for GDM (85.9% and 88.5% vs. 69.0%; p < 0.0001), and had higher rates of type 2 diabetes/prediabetes at 5 years (50.0% and 48.8% vs. 28.3%; p = 0.03). Their infants were born earlier (38.1 and 38.0 vs. 38.6 weeks; p = 0.02) with higher birthweight z‐scores (0.2 and 0.1 vs. −0.2; p = 0.03). Infants in the fasting group, compared with infants in the one‐hour group, had higher rates of being large‐for‐gestational age and neonatal intensive care unit admission. At 5 years, children in the fasting group, compared with those in the one‐hour group, had higher mean z‐scores in weight and height, and were more likely to have an abnormal developmental screening questionnaire score (24.4% vs. 5.1%; p = 0.04). Conclusions Women diagnosed with GDM based on an elevated FPG, compared with those with only an elevated 1‐h PLG, may have had increased diabetes risks at five‐year follow‐up, while their children may have greater infant health risks and greater growth at 5 years. 10.1111/aogs.70191 http://creativecommons.org/licenses/by-nc/4.0/ |
| doi_str_mv | 10.1111/aogs.70191 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_aogs_70191 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by-nc/4.0/ |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Perinatal and long‐term implications of diagnosing gestational diabetes mellitus using only fasting and one‐hour post‐load glucose concentrations: Secondary analysis of the GEMS trial and its five‐year follow‐up Qiliang Liu Jane E. Harding Greg D. Gamble Carl Eagleton Lisa Dawes Caroline A. Crowther Acta Obstetricia et Gynecologica Scandinavica Perinatal and long‐term implications of diagnosing gestational diabetes mellitus using only fasting and one‐hour post‐load glucose concentrations: Secondary analysis of the GEMS trial and its five‐year follow‐up Qiliang Liu Jane E. Harding Greg D. Gamble Carl Eagleton Lisa Dawes Caroline A. Crowther Acta Obstetricia et Gynecologica Scandinavica Abstract Introduction The proposed revised diagnostic criteria for gestational diabetes (GDM) in New Zealand include a fasting plasma glucose (FPG) concentration ≥5.3 mmol/L and 1‐h post‐load glucose (PLG) concentration ≥10.6 mmol/L on a 75 g oral glucose tolerance test (OGTT), but no 2‐h PLG. This study evaluates the impact of GDM diagnosis based on FPG and/or 1‐h PLG abnormalities on perinatal and long‐term outcomes. Material and Methods This secondary analysis of data from GEMS, a multicentre, randomized trial and its follow‐up, included women and their children who met the proposed revised GDM criteria and received treatment. Participants were classified into three groups: (1) both group: elevated FPG and 1‐h PLG, (2) fasting group: elevated FPG alone, and (3) one‐hour group: elevated 1‐h PLG alone. Between‐group pairwise comparisons were made using log‐binomial and normal‐identity regressions. Results Of 217 eligible women‐child pairs, 85 (39.2%) were in the fasting group, 61 (28.1%) in the both group, and 71 (32.7%) in the one‐hour group. Women in the fasting and both groups, compared with the one‐hour group, were more likely to be overweight or obese both at the first antenatal visit and five‐year follow‐up, more likely to have required pharmacotherapy for GDM (85.9% and 88.5% vs. 69.0%; p < 0.0001), and had higher rates of type 2 diabetes/prediabetes at 5 years (50.0% and 48.8% vs. 28.3%; p = 0.03). Their infants were born earlier (38.1 and 38.0 vs. 38.6 weeks; p = 0.02) with higher birthweight z‐scores (0.2 and 0.1 vs. −0.2; p = 0.03). Infants in the fasting group, compared with infants in the one‐hour group, had higher rates of being large‐for‐gestational age and neonatal intensive care unit admission. At 5 years, children in the fasting group, compared with those in the one‐hour group, had higher mean z‐scores in weight and height, and were more likely to have an abnormal developmental screening questionnaire score (24.4% vs. 5.1%; p = 0.04). Conclusions Women diagnosed with GDM based on an elevated FPG, compared with those with only an elevated 1‐h PLG, may have had increased diabetes risks at five‐year follow‐up, while their children may have greater infant health risks and greater growth at 5 years. 10.1111/aogs.70191 http://creativecommons.org/licenses/by-nc/4.0/ |
| title | Perinatal and long‐term implications of diagnosing gestational diabetes mellitus using only fasting and one‐hour post‐load glucose concentrations: Secondary analysis of the GEMS trial and its five‐year follow‐up |
| topic | Acta Obstetricia et Gynecologica Scandinavica |
| url | https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.70191 |