{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:17:54Z","timestamp":1792181874955,"version":"4.4.0"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Gestational diabetes mellitus (GDM) has a rapidly increasing prevalence, which poses challenges to obstetric care and service provision, with known serious long-term impacts on the metabolic health of the mother and the affected offspring. The aim of this study was to evaluate the association between glucose levels on the 75 g oral glucose tolerance test and GDM treatment and outcomes. We performed a retrospective cohort study of women with GDM attending a tertiary Australian hospital obstetric clinic between 2013 and 2017, investigating the relationship between the 75 g oral glucose tolerance test (OGTT) glucose values, and obstetric (timing of delivery, caesarean section, preterm birth, preeclampsia), and neonatal (hypoglycaemia, jaundice, respiratory distress and NICU admission) outcomes. This time frame encompassed a change in diagnostic criteria for gestational diabetes, due to changes in international consensus guidelines. Our results showed that, based on the diagnostic 75 g OGTT, fasting hyperglycaemia, either alone or in combination with elevated 1 or 2 h glucose levels, was associated with the need for pharmacotherapy with either metformin and\/or insulin (p &lt; 0.0001; HR 4.02, 95% CI 2.88\u20135.61), as compared to women with isolated hyperglycaemia at the 1 or 2 h post-glucose load timepoints. Fasting hyperglycaemia on the OGTT was more likely in women with higher BMI (p &lt; 0.0001). There was an increased risk of early term birth in women with mixed fasting and post-glucose hyperglycaemia (adjusted HR 1.72, 95% CI 1.09\u20132.71). There were no significant differences in rates of neonatal complications such as macrosomia or NICU admission. Fasting hyperglycaemia, either alone or in combination with post-glucose elevations on the OGTT, is a strong indicator of the need for pharmacotherapy in pregnant women with GDM, with significant ramifications for obstetric interventions and their timing.<\/jats:p>","DOI":"10.3390\/nu15051226","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T01:36:09Z","timestamp":1677634569000},"page":"1226","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Fasting Glucose Level on the Oral Glucose Tolerance Test Is Associated with the Need for Pharmacotherapy in Gestational Diabetes Mellitus"],"prefix":"10.3390","volume":"15","author":[{"given":"Natassia","family":"Rodrigo","sequence":"first","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonard\u2019s, NSW 2065, Australia"},{"name":"North Precinct, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia"},{"name":"Kolling Institute of Medical Research, Northern Sydney Local Health District, St Leonard\u2019s, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Randall","sequence":"additional","affiliation":[{"name":"Kolling Institute of Medical Research, Northern Sydney Local Health District, St Leonard\u2019s, NSW 2065, Australia"},{"name":"Women\u2019s and Babies Research, Northern Clinical School, The University of Sydney, St Leonard\u2019s, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Abu","family":"Al-Hial","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonard\u2019s, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen L. M.","family":"Pak","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonard\u2019s, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander Junmo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonard\u2019s, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9317-1348","authenticated-orcid":false,"given":"Sarah J.","family":"Glastras","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonard\u2019s, NSW 2065, Australia"},{"name":"North Precinct, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia"},{"name":"Kolling Institute of Medical Research, Northern Sydney Local Health District, St Leonard\u2019s, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2003). 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