Patient Preferences, Beliefs, and Experiences Regarding Oral Intake and the 1-Hour Oral Glucose Tolerance Test

The 1-hour oral glucose tolerance test (OGTT) is the primary test used for gestational diabetes mellitus (GDM) screening in the US and was designed to be administered without regard to time of day or last meal. We examined patient preferences, beliefs, and experiences regarding oral intake and their perceived effect of oral intake on the 1-hr OGTT. This was a secondary analysis of a single-center randomized trial that investigated the effect of oral intake on the 1-hour OGTT. Following the OGTT, participants completed an electronic survey querying their oral intake, and how they believed fasting versus eating within 2 hours of the OGTT would affect screening results. Patients were then asked what their preferences would be for preparing for the test, and whether they received oral intake recommendations from a provider in prior pregnancies before the OGTT. All 195 participants who completed the 1-hr OGTT completed the survey. Among participants, 19.8% (n= 38) believed fasting would increase the glucose level, 49.2% (n=95) believed fasting would decrease the glucose level, and 31.1% (n=60) believed fasting would not affect the glucose level (Figure 1). If given a choice, 71.0% (n=137) of participants would prefer to eat without restriction prior to the OGTT and 29.0% (n= 56) would prefer to fast for 6 or more hours prior. 89 (45.6%) respondents had taken the OGTT in a prior pregnancy, with 19.1% (n=17) reporting that a provider gave recommendations about oral intake before the test. Seven (41.2%) of these participants were told to fast or not eat for 8 hours or more, 3 (17.6%) were told to not eat for 1-2 hours prior, 3 (17.6%) were told to limit carbohydrates, and 4 (23.5%) did not specify the recommendation given (Figure 2). While most respondents would prefer to eat within 2 hours of the 1-hr OGTT, the majority believed fasting prior to the 1-hr OGTT would lead to a lower glucose value compared to eating within 2 hours of the test. Objective data on the effect of oral intake prior to the OGTT are warranted to inform appropriate recommendations.View Large Image Figure ViewerDownload Hi-res image Download (PPT)