COVID-19 pandemic: Can fasting plasma glucose and HbA1c replace the oral glucose tolerance test to screen for hyperglycaemia in pregnancy?. (February 2021)

• Record Type: Journal Article
• Authors: Nachtergaele, Charlotte; Vicaut, Eric; Pinto, Sara; Tatulashvili, Sopio; Bihan, Hélène; Sal, Meriem; Berkane, Narimane; Allard, Lucie; Baudry, Camille; Carbillon, Lionel; Cosson, Emmanuel
• Is Part Of: Diabetes research and clinical practice. Volume 172(2021)
• Publication Date: 2021-02
• Subjects: Collège National des Gynécologues Obstétriciens Français (CNGOF) -- COVID-19 -- HbA1c -- Oral glucose tolerance test -- Société Francophone du Diabète (SFD); 1h-PG plasma glucose value 1 hour after 75g oral glucose tolerance test -- 2h-PG plasma glucose value 2 hours after 75g oral glucose tolerance test -- CNGOF French National College of Obstetricians and Gynecologists (Collège National des Gynécologues et Obstétriciens Français) -- COVID-19 Coronarovirus Disease 19 -- DIP diabetes in pregnancy -- FPG fasting plasma glucose -- GDM gestational diabetes mellitus -- HIP hyperglycaemia in pregnancy -- IADPSG International Association of Diabetes Pregnancy Study Group -- NICE National Institute for Health and Care Excellence -- OGTT 75-g oral glucose tolerance test -- SD standard deviation -- SFD French-speaking Society of Diabetes (Société Francophone du Diabète) -- WG weeks of gestation -- WHO World Health Organization; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108640
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: To evaluate proposals considering HbA1c and fasting plasma glucose (FPG) measurement as a substitute for oral glucose tolerance test (OGTT) to diagnose hyperglycaemia in pregnancy (HIP) during COVID-19 pandemic. Methods: Of the 7, 334 women who underwent the OGTT between 22 and 30 weeks gestation, 966 had HIP (WHO diagnostic criteria, reference standard). The 467 women who had an available HbA1c were used for analysis. French-speaking Society of Diabetes (SFD) proposal to diagnose HIP during COVID-19 pandemic was retrospectively applied: HbA1c ≥5.7% (39 mmol/mol) and/or FPG level ≥5.1 mmol/l. SFD proposal sensitivity for HIP diagnosis and the occurrence of HIP-related events (preeclampsia, large for gestational age infant, shoulder dystocia or neonatal hypoglycaemia) in women with false negative (FN) and true positive (TP) HIP-diagnoses were evaluated. Results: The sensitivity was 57% [95% confidence interval 52–62]. FN women had globally lower plasma glucose levels during OGTT, lower HbA1c and body mass index than those TP. The percentage of HIP-related events was similar in FN (who were cared) and TP cases, respectively 19.5 and 16.9% (p = 0.48). We observed similar results when women at high risk for HIP only were considered. Conclusion: The SFD proposal has a poor sensitivity to detect HIP. Furthermore, it fails to have any advantages in predicting adverse outcomes.