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Diabetes, GestationalNCT03117543

Diagnostic Approaches in Gestational Diabetes and Impact of Ethnicity

An observational study of Diabetes, Gestational, run by King's College Hospital NHS Trust at 1 site in United Kingdom.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Gestational diabetes (GDM) means raised blood glucose found for the first time in pregnancy. GDM is common, particularly in women from minority ethnicities. GDM does not cause any symptoms in the mother. GDM is associated with adverse pregnancy outcomes which can be improved with treatment of GDM. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Diabetes, Gestational
How many people
152 participants
Where
1 siteUnited Kingdom
Study dates
Mar 2016to 30 Apr 2019
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Study population: Pregnant women

Who may be able to join

  • Main study:
  • Pregnant woman at least 18 years of age
  • 16-34 weeks gestation.
  • Booked for pregnancy care at a participating centre
  • Able to give informed consent to participate
  • Substudy:
  • In addition to the inclusion criteria of main study:
  • Women who are of White European, Black African or Black Caribbean ethnicity.

Who cannot join

  • Main study
  • Unable to give informed consent
  • Known pre-pregnancy diabetes
  • GDM diagnosed in the current pregnancy
  • Substudy
  • In addition to main study criteria:
  • Women known to have sickle cell anaemia or thalassaemia.

Trial locations and contacts

1 site in 1 country.

Katharine F Hunt, MBBS MRCP contact

00442078485663

katharine.f.hunt@kcl.ac.uk

Stephanie A Amiel, MBBS MD FRCP contact

00442078485639

stephanie.amiel@kcl.ac.uk

United Kingdom1 site, 1 recruiting
  • Clinical Research Facility, King's College Hospital NHS Foundation Trust

    London, SE5 9PJ

    Elka Giemza, rgiemza@nhs.net

    Recruiting

Other trials in United Kingdom

About this study

Official title: Screening and Diagnostic Approaches in Gestational Diabetes (GDM) and the Impact of Ethnicity on Markers of Glycaemia in Pregnancy

Gestational diabetes (GDM) means raised blood glucose found for the first time in pregnancy. GDM is common, particularly in women from minority ethnicities. GDM does not cause any symptoms in the mother. GDM is associated with adverse pregnancy outcomes which can be improved with treatment of GDM. The United Kingdom National Institute for Health and Care Excellence (NICE) recommend pregnant women with one or more risk factors should have a 75g oral glucose tolerance test (OGTT). The OGTT is performed in a clinic with venous plasma glucose measured fasting and at 2 hours. This is resource-intensive, and some women with GDM may be missed by this risk-factor based approach. The International Association of Diabetes and Pregnancy Study Groups (IADPSG 2010) recommends screening all pregnant women with 2-hour, 3 sample (fasting, 1 and 2 hour), 75g OGTT, which is even more resource intensive. Developing more cost-effective and convenient approaches to screening for GDM is a priority.

The researchers will validate a new home-use OGTT system (hOGTT), which measures whole blood glucose in capillary blood ('finger-stick' sample), against the gold standard venous plasma glucose in pregnancy.

Read more

The researchers will also investigate the performance of glycated haemoglobin (HbA1c) in screening for GDM. HbA1c is used for diagnosis of diabetes outside of pregnancy, but is currently not recommended for screening for GDM.

The researchers will also investigate relationships between glucose measured in different samples (venous versus capillary), different fractions (plasma versus whole blood), and using different methods in pregnancy.

In a substudy the researchers will investigate: ethnic differences in HbA1c and other glycaemic markers; the contribution of fasting and postprandial glucose handling, diet and ethnicity on HbA1c; and ethnic differences in insulin responses to 75g OGTT in pregnancy.

The researchers will invite pregnant women between 16-34 weeks gestation to participate. The research involves one hospital visit for an OGTT. Participants will have venous blood samples taken fasting and at 1-hour and 2-hours, and at the same times finger-stick blood samples will be tested. The researchers will invite women of Black African, Black Caribbean and White European ethnicity to participate in a substudy in which participants will have extra blood taken and a diet assessment.

If the hOGTT provides accurate results in pregnancy, using it to perform OGTTs at home would make screening for GDM less expensive and more convenient and may facilitate universal screening for GDM. Understanding ethnic differences in HbA1c will help determine if HbA1c is a reliable screening tool for GDM in our ethnically diverse local population.

Keywords
Screening
Medical subject headings
Diabetes, Gestational

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of hOGTT venous plasma equivalent glucose (hOGTT-VPEqG) results within ±10% of paired venous plasma glucose measured on a YSI analyser (VPG-YSI) (reference standard).

    hOGTT-VPEqG (in mmol/l) is capillary whole blood glucose measured on the home Oral Glucose Tolerance Test (hOGTT) system (the device being evaluated) expressed as venous plasma equivalent glucose (VPEqG).

    VPG-YSI (in mmol/l) is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    Paired means samples taken at the same time.

    Results will be reported for glucose (VPG-YSI) range 4.5-11mmol/L. This was chosen because it encompasses the GDM diagnostic cut-offs for both National Institute for Health and Care Excellence (NICE) 2015 and International Association of Diabetes and Pregnancy Study Groups (IADPSG) 2010 criteria.

    Samples taken fasting and at 1 hour and 2 hours post 75g oral glucose load will be considered together in this analysis.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

Secondary outcomes (14)
  1. Percentage of hOGTT venous plasma equivalent glucose (hOGTT-VPEqG) results within ±15% of paired venous plasma glucose measured on a YSI analyser (VPG-YSI) (reference standard).

    hOGTT-VPEqG (in mmol/l) is capillary whole blood glucose measured on the home Oral Glucose Tolerance Test (hOGTT) system (the device being evaluated) expressed as venous plasma equivalent glucose (VPEqG).

    VPG-YSI (in mmol/l) is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    Paired means samples taken at the same time.

    Results will be reported for glucose (VPG-YSI) range 4.5-11mmol/L. This was chosen because it encompasses the GDM diagnostic cut-offs for both National Institute for Health and Care Excellence (NICE) 2015 and International Association of Diabetes and Pregnancy Study Groups (IADPSG) 2010 criteria.

    Samples taken fasting and at 1 hour and 2 hours post 75g oral glucose load will be considered together in this analysis.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  2. Percentage of hOGTT venous plasma equivalent glucose (hOGTT-VPEqG) results within ±20% of paired venous plasma glucose measured on a YSI analyser (VPG-YSI) (reference standard).

    hOGTT-VPEqG (in mmol/l) is capillary whole blood glucose measured on the home Oral Glucose Tolerance Test (hOGTT) system (the device being evaluated) expressed as venous plasma equivalent glucose (VPEqG).

    VPG-YSI (in mmol/l) is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    Paired means samples taken at the same time.

    Results will be reported for glucose (VPG-YSI) range 4.5-11mmol/L. This was chosen because it encompasses the GDM diagnostic cut-offs for both National Institute for Health and Care Excellence (NICE) 2015 and International Association of Diabetes and Pregnancy Study Groups (IADPSG) 2010 criteria.

    Samples taken fasting and at 1 hour and 2 hours post 75g oral glucose load will be considered together in this analysis.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  3. Sensitivity of the hOGTT system for diagnosis of GDM using NICE 2015 criteria (gold standard VPG-YSI).

    VPG-YSI is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    NICE (National Institute for Health and Care Excellence) 2015 diagnostic criteria for GDM are: fasting venous plasma glucose ≥ 5.6mmol/L, 2-hour post 75g oral glucose venous plasma glucose ≥ 7.8mmol/L.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  4. Specificity of the hOGTT system for diagnosis of GDM using NICE 2015 criteria (gold standard VPG-YSI).

    VPG-YSI is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    NICE (National Institute for Health and Care Excellence) 2015 diagnostic criteria for GDM are: fasting venous plasma glucose ≥ 5.6mmol/L, 2-hour post 75g oral glucose venous plasma glucose ≥ 7.8mmol/L.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  5. Sensitivity of the hOGTT system for diagnosis of GDM using IADPSG 2010 criteria (gold standard VPG-YSI).

    VPG-YSI is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    IADPSG (the International Association of Diabetes and Pregnancy Study Groups) 2010 diagnostic criteria for GDM are: 1 or more of fasting venous plasma glucose ≥ 5.1mmol/L, 1-hour post 75g oral glucose venous plasma glucose ≥ 10.0mmol/L or 2-hour post 75g oral glucose venous plasma glucose ≥ 8.5mmol/L.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  6. Specificity of the hOGTT system for diagnosis of GDM using IADPSG 2010 criteria (gold standard VPG-YSI).

    VPG-YSI is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    IADPSG (the International Association of Diabetes and Pregnancy Study Groups) 2010 diagnostic criteria for GDM are: 1 or more of fasting venous plasma glucose ≥ 5.1mmol/L, 1-hour post 75g oral glucose venous plasma glucose ≥ 10.0mmol/L or 2-hour post 75g oral glucose venous plasma glucose ≥ 8.5mmol/L.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  7. Relationship between whole blood and plasma glucose in capillary blood samples in pregnancy.

    In capillary blood samples, glucose will be measured in both whole blood and plasma on the YSI analyser. The relationship between whole blood and plasma glucose measurements will be reported.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  8. Relationship between whole blood and plasma glucose in venous blood samples in pregnancy.

    In venous blood samples, glucose will be measured in both whole blood and plasma on the YSI analyser. The relationship between whole blood and plasma glucose measurements will be reported.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  9. Relationship between capillary whole blood and venous whole blood glucose in pregnancy.

    Glucose will be measured on the YSI analyser in paired capillary whole blood and venous whole blood samples. The relationship between capillary and venous whole blood glucose will be reported.

    Paired means samples taken at the same time.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  10. Relationship between capillary plasma glucose and venous plasma glucose in pregnancy.

    Glucose will be measured on the YSI analyser in paired capillary plasma and venous plasma samples. The relationship between capillary and venous plasma glucose will be reported.

    Paired means samples taken at the same time.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  11. Sensitivity of HbA1c for screening for GDM versus gold standard of 75g OGTT and VPG-YSI measurement (NICE 2015 criteria).

    HbA1c (haemoglobin A1c, glycated haemoglobin) measured on venous whole blood in a hospital laboratory (IFCC standardised).

    VPG-YSI is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    NICE (National Institute for Health and Care Excellence) 2015 diagnostic criteria for GDM are: fasting venous plasma glucose ≥ 5.6mmol/L, 2-hour post 75g oral glucose venous plasma glucose ≥ 7.8mmol/L.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  12. Specificity of HbA1c for screening for GDM versus gold standard of 75g OGTT and VPG-YSI measurement (NICE 2015 criteria).

    HbA1c (haemoglobin A1c, glycated haemoglobin) measured on venous whole blood in a hospital laboratory (IFCC standardised).

    VPG-YSI is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    NICE (National Institute for Health and Care Excellence) 2015 diagnostic criteria for GDM are: fasting venous plasma glucose ≥ 5.6mmol/L, 2-hour post 75g oral glucose venous plasma glucose ≥ 7.8mmol/L.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  13. Sensitivity of HbA1c for screening for GDM versus gold standard of 75g OGTT and VPG-YSI measurement (IADPSG 2010 criteria).

    HbA1c (haemoglobin A1c, glycated haemoglobin) measured on venous whole blood in a hospital laboratory (IFCC standardised).

    VPG-YSI is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    IADPSG (the International Association of Diabetes and Pregnancy Study Groups) 2010 diagnostic criteria for GDM are: 1 or more of fasting venous plasma glucose ≥ 5.1mmol/L, 1-hour post 75g oral glucose venous plasma glucose ≥ 10.0mmol/L or 2-hour post 75g oral glucose venous plasma glucose ≥ 8.5mmol/L.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

  14. Specificity of HbA1c for screening for GDM versus gold standard of 75g OGTT and VPG-YSI measurement (IADPSG 2010 criteria).

    HbA1c (haemoglobin A1c, glycated haemoglobin) measured on venous whole blood in a hospital laboratory (IFCC standardised).

    VPG-YSI is venous plasma glucose measured on YSI 2300 Stat Analyser (YSI Life Sciences), a recognised reference standard, average of 2 measurements.

    IADPSG (the International Association of Diabetes and Pregnancy Study Groups) 2010 diagnostic criteria for GDM are: 1 or more of fasting venous plasma glucose ≥ 5.1mmol/L, 1-hour post 75g oral glucose venous plasma glucose ≥ 10.0mmol/L or 2-hour post 75g oral glucose venous plasma glucose ≥ 8.5mmol/L.

    Measured: Each participant is studied on one occasion between 16-34 weeks gestation.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Apr 2017
  2. Study startMar 2016
  3. Primary completion30 Apr 2019 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Cross-sectional
Enrolment
152 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03117543
Sponsor's protocol ID
KCH16-035
Other IDs
15/LO/1494, 180588
Status last verified
Oct 2018
First submitted
11 Jul 2016
Last updated
18 Oct 2018
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Diabetes, Gestational, run by King's College Hospital NHS Trust at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 18 Oct 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Katharine F Hunt, MBBS MRCP (00442078485663, katharine.f.hunt@kcl.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of hOGTT venous plasma equivalent glucose (hOGTT-VPEqG) results within ±10% of paired venous plasma glucose measured on a YSI analyser (VPG-YSI) (reference standard). (time frame: Each participant is studied on one occasion between 16-34 weeks gestation.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Oct 2018.

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