Role of A1c in the postpartum screening of women with gestational diabetes

• Published in: Gynecological endocrinology Vol. 29; no. 7; pp. 687 - 690
• Main Authors: Benaiges, D., Chillaron, J.J., Pedro-Botet, J., Mas, A., Puig de Dou, J., Sagarra, E., Carrera, M.J., Goday, A., Flores- Le Roux, J.A.
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01.07.2013; Taylor & Francis
• Subjects: Adult; Body Mass Index; Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Diabetes, Gestational - metabolism; Female; Gestational diabetes; Glucose Intolerance - blood; Glucose Intolerance - diagnosis; Glucose Intolerance - epidemiology; Glucose Tolerance Test; Glycated Hemoglobin A - analysis; glycosylated haemoglobin; Humans; impaired glucose tolerance; Insulin Resistance; Mass Screening - methods; Postpartum Period - blood; prediabetes; Prediabetic State - blood; Prediabetic State - diagnosis; Prediabetic State - epidemiology; Pregnancy; Prevalence; type 2 diabetes
• ISSN: 0951-3590; 1473-0766
• DOI: 10.3109/09513590.2013.788639

Abstract Objective: This study aimed to determine whether A1c detects a different prediabetes prevalence in women with a history of gestational diabetes mellitus (GDM) compared to those diagnosed with oral glucose tolerance test (OGTT) and the influence of haemoglobin concentrations on A1c levels. Design and patients: We evaluated carbohydrate metabolism status by performing OGTT and A1c tests in 141 postpartum women with prior GDM in the first year post-delivery. Results: The overall prevalence of prediabetes was 41.8%. Prevalence of isolated A1c 5.7-6.4%, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) was 10.6%, 7.1%, and 9.2%, respectively. Isolated A1c 5.7-6.4% was associated with Caucasian origin (66.7% versus 32.6%, p = 0.02) and with higher LDL cholesterol concentrations (123 ± 28.4 mg/dl versus 101.6 ± 19.2 mg/dl, p = 0.037) compared with patients diagnosed by OGTT (IFG or IGT). Women with postpartum anaemia had similar A1c levels to those with normal haemoglobin concentrations (5.5% ± 0.6% versus 5.4% ± 0.4%, p = 0.237). Conclusions: Use of A1c in postpartum screening of women with GDM detected an additional 10.6% of patients with prediabetes and a more adverse lipid profile. Haemoglobin concentrations did not influence A1c values.