Glycated haemoglobin in the first trimester: A predictor of gestational diabetes mellitus in pregnant Asian Indian women. (January 2020)

• Record Type: Journal Article
• Authors: Punnose, John; Malhotra, Rajeev Kumar; Sukhija, Komal; Mathew, Anu; Sharma, Asha; Choudhary, Naimaa
• Is Part Of: Diabetes research and clinical practice. Volume 159(2020)
• Publication Date: 2020-01
• Subjects: Gestational diabetes -- Asian Indian women -- Glycated hemoglobin -- Oral glucose tolerance test; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2019.107953
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: HbA1c in first trimester is a predictor of gestational diabetes in Asian Indian women. First trimester HbA1c is not a sensitive or specific test for gestational diabetes diagnosis. Gestational diabetes emerged before 24 gestational weeks in 36.5% of women in this study. Abstract: Aim: To assess the efficacy of first trimester glycated hemoglobin (HbA1c-FT) in diagnosing or predicting gestational diabetes mellitus (GDM) in Asian Indian women. Methods: This retrospective cohort study involved 2275 women who underwent both HbA1c-FT estimation and GDM screening with a one-step 75 g oral glucose tolerance test. Receiver Operating Characteristic (ROC) curve statistics were applied to assess the discriminative ability of HbA1c-FT in GDM diagnosis. A multivariable logistic regression analysis after adjusting for plausible confounders was used to evaluate the independent effect of HbA1c-FT on GDM diagnosis. Results: The mean HbA1c-FT of GDM (n = 578) and non-GDM women (n = 1697) were 5.04 + 0.04% and 4.9 + 0.37%, respectively (p < 0.001). Compared to women with a HbA1c-FT < 5.2%, the adjusted odds ratio to develop GDM of women with an HbA1c–FT range of 5.2–5.5% and those >5.6% to develop GDM were 1.627 (p < 0.004) and 2.6 (p < 0.001), respectively. The area under the ROC curve to detect GDM was 0.606 (95% CI: 0.519–0.633 p < 0.001), but the sensitivity and specificity of the HbA1c-FT were not sufficient to diagnose, rule in or rule out GDM. Conclusions: HbA1c-FT is an independent GDM predictor in Asian Indian women but lacks sufficient sensitivity or specificity for use as a diagnostic test.