Advertisement

 

 

HbA1c as a predictor of diabetes after gestational diabetes mellitus.

HbA1c as a predictor of diabetes after gestational diabetes mellitus.
Author Information (click to view)

Claesson R, Ignell C, Shaat N, Berntorp K,


Claesson R, Ignell C, Shaat N, Berntorp K, (click to view)

Claesson R, Ignell C, Shaat N, Berntorp K,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Primary care diabetes 2016 09 2811(1) 46-51 pii S1751-9918(16)30098-5
Abstract
AIM
We wanted to investigate third-trimester HbA1c as a predictor of diabetes after gestational diabetes mellitus (GDM).

METHODS
Women with GDM were followed up prospectively for five years from pregnancy to detect the development of diabetes. The ability of HbA1c to predict diabetes was evaluated with receiver-operating characteristic (ROC) curves and logistic regression analysis.

RESULTS
By five years, 73 of 196 women had been diagnosed with diabetes. An optimal cut-off point for HbA1c of 36mmol/mol (5.4%) could predict diabetes with 45% sensitivity and 92% specificity. For HbA1c ≥39mmol/mol (≥5.7%), sensitivity, specificity, and positive predictive value were 30%, 97%, and 91%, respectively. In logistic regression analysis, adjusting for the diagnostic glucose concentration during pregnancy, HbA1c levels in the upper quartile (≥36mmol/mol) were associated with a 5.5-fold increased risk of diabetes.

CONCLUSION
Third-trimester HbA1c levels in the pre-diabetes range revealed women with post-partum diabetes with high specificity and high positive predictive value. HbA1c testing could be used as a strategy to select high-risk women for lifestyle interventions aimed at prevention of diabetes starting during pregnancy. The results should encourage further validation in other populations using new diagnostic criteria for GDM.

Submit a Comment

Your email address will not be published. Required fields are marked *

15 − one =

[ HIDE/SHOW ]