DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20211174

Glycosylated hemoglobin as an efficacious tool for early prediction of gestational diabetes mellitus

Sneha D. Shendre, Vijayalakshmi Palanisamy, Swanand S. Rewatkar

Abstract


The incidence and prevalence of GDM is on the rise worldwide and, more so in developing countries including India. GDM is associated with maternal, fetal and neonatal morbidities. Current guidelines recommend GDM screening only at 24-28 weeks of gestation. Diagnosis of GDM in later half of pregnancy leads to fetal and maternal morbidities in spite of good glycemic control. This necessitates the use of a simpler, convenient, accurate, and reliable test, which can predict GDM in early gestation. Our article reviews the scope of using HbA1c for GDM and its efficacy in screening GDM.


Keywords


Gestational diabetes mellitus, HbA1c, OGTT, Screening test, First trimester screening

Full Text:

PDF

References


Mahalakshmi MM, Bhavadharini B, Maheswari Kumar RM, Shah SS, Bridgette A, Choudhury M, et al. Clinical profile, outcomes, and progression to type 2 diabetes among Indian women with gestational diabetes mellitus seen at a diabetes center in south India. Indian J Endocrinol Metab. 2014;18(3):400-6.

Yogev Y, Visser GH. Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med. 2009;14(2):77-84.

Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research–INdiaDIABetes (ICMR–INDIAB) study. Diabetologia. 2011;54(12):3022-7.

Mithal A, Bansal B, Kalra S. Gestational diabetes in India: Science and society. Indian J Endocrinol Metab. 2015;19(6):701-4.

Abate N, Chandalia M. Ethnicity, type 2 diabetes & migrant Asian Indians. Indian J Med Res. 2007;125(3):251-8.

Casey BM, Lucas MJ, McIntire DD, Leveno KJ. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol. 1997;90(6):869-73.

Dang K, Homko C, Reece EA. Factors associated with fetal macrosomia in offspring of gestational diabetic women. J Matern Fetal Med. 2000;9(2):114-7.

Hillier TA, Pedula KL, Schmidt MM, Mullen JA, Charles MA, Pettitt DJ. Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia. Diabetes care. 2007;30(9):2287-92.

Naylor CD, Sermer M, Chen E, Sykora K. Cesarean delivery in relation to birth eight and gestational glucose tolerance: pathophysiology or practice style?. JAMA. 1996;275(15):1165-70.

Yogev Y, Ben-Haroush A, Chen R, Glickman H, Kaplan B, Hod M. Active induction management of labor for diabetic pregnancies at term; mode of delivery and fetal outcome-a single center experience. Eur J Obstet Gynecol Reprod Biol. 2004;114(2):166-70.

Balaji V, Madhuri BS, Ashalatha S, Sheela S, Suresh S, Seshiah V. A1C in gestational diabetes mellitus in Asian Indian women. Diabetes care. 2007;30(7):1865-7.

Balaji V, Balaji MS, Seshiah V, Mukundan S, Datta M. Maternal glycemia and neonates birth weight in Asian Indian women. Diabetes Res Clin Pract. 2006;73(2):223-4.

Amreen S, Suneel A, Shetty A, Vasudeva A, Kumar P. Use of glycosylated HbA1c and random blood sugar as a screening tool for gestational diabetes mellitus in first trimester. Int J Reprod Contracept Obstet Gynecol. 2018;7(2):524-8.

Cefalu WT, Berg EG, Saraco M, Petersen MP, Uelmen S, Robinson S. Classification and diagnosis of diabetes: standards of medical care in diabetes-2019. Diabetes Care. 2019;42:S13-28.

Karakash SD, Einstein FH. Diabetes in pregnancy: glycemia control guidelines and rationale. Curr Opin Endocrinol Diabetes Obes. 2011;18(2):99-103.

Angueira AR, Ludvik AE, Reddy TE, Wicksteed B, Lowe WL, Layden BT. New insights into gestational glucose metabolism: lessons learned from 21st century approaches. Diabetes. 2015;64(2):327-34.

Di Cianni G, Miccoli RO, Volpe LA, Lencioni C, Del Prato ST. Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metab Res Rev. 2003;19(4):259-70.

Butte NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr. 2000;71(5):1256S-61S.

Newbern D, Freemark M. Placental hormones and the control of maternal metabolism and fetal growth. Curr Opin Endocrinol Diabetes Obes. 2011;18(6):409-16.

Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci. 2018;19(11):3342.

Patti ME, Corvera S. The role of mitochondria in the pathogenesis of type 2 diabetes. Endocrine Reviews. 2010;31(3):364-95.

Homko C, Sivan E, Chen X, Reece EA, Boden G. Insulin secretion during and after pregnancy in patients with gestational diabetes mellitus. J Clin Endocrinol Metab. 2001;86(2):568-73.

Catalano PM, Tyzbir ED, Roman NM, Amini SB, Sims EA. Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women. Am J Obstet Gynecol. 1991;165(6):1667-72.

Cheung NW, Wasmer G, Al-Ali J. Risk factors for gestational diabetes among Asian women. Diabetes Care. 2001;24(5):955-6.

Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2018;18(1):494.

Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY (editors). Williams Obstetrics. 25thed. New York: McGraw-Hill Education; 2018;7:2444-8.

Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY (editors). Williams Obstetrics. 25thed. New York: McGraw-Hill Education; 2018;57:2437-42.

Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY (editors). Williams Obstetrics. 25thed. New York: McGraw-Hill Education; 2018;57:2442-4.

Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676-82.

Fuller KP, Borgida AF. Gestational diabetes mellitus screening using the one-step versus two-step method in a high-risk practice. Clin Diabetes. 2014;32(4):148-50.

Kobold U, Jeppsson JO, Dulffer T, Finke A, Hoelzel W, Miedema K. Candidate reference methods for hemoglobin A1c based on peptide mapping. Clin Chem. 1997;43(10):1944-51.

Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J. 2014;7(1):45-8.

Agarwal MM, Dhatt GS, Punnose J, Koster G. Gestational diabetes: a reappraisal of HBA1c as a screening test. Acta Obstet Gynecol Scand. 2005;84(12):1159-63.

Aldasouqi SA, Solomon DJ, Bokhari SA, Khan PM, Muneera S, Gossain VV. GlycohemoglobinA1c: a promising screening tool in gestational diabetes mellitus. Int J Diabetes Dev Ctries. 2008;28(4):121-4.

Arbib N, Shmueli A, Salman L, Krispin E, Toledano Y, Hadar E. First trimester glycosylated hemoglobin as a predictor of gestational diabetes mellitus. Int J Gynaecol Obstet. 2019;145(2):158-63.

Duke A, Yap C, Bradbury R, Hng TM, Kim C, Wansbrough A, et al. The discordance between HbA1c and glucose tolerance testing for the postpartum exclusion of diabetes following gestational diabetes. Diabetes Res Clin Pract. 2015;108(1):72-7.

Hughes RC, Moore MP, Gullam JE, Mohamed K, Rowan J. An early pregnancy HbA1c≥ 5.9%(41 mmol/mol) is optimal for detecting diabetes and identifies women at increased risk of adverse pregnancy outcomes. Diabetes Care. 2014;37(11):2953-9.

Odsæter IH, Åsberg A, Vanky E, Mørkved S, Stafne SN, Salvesen KÅ, Carlsen SM. Hemoglobin A1c as screening for gestational diabetes mellitus in Nordic Caucasian women. Diabetol Metab Syndr. 2016;8(1):43.

Rajput R, Rajput M, Nanda S. Utility of HbA1c for diagnosis of gestational diabetes mellitus. Diabetes Res Clin Pract. 2012;98(1):104-7.

Renz PB, Cavagnolli G, Weinert LS, Silveiro SP, Camargo JL. HbA1c test as a tool in the diagnosis of gestational diabetes mellitus. PLoS One. 2015;10(8):e0135989.

Ryu AJ, Moon HJ, Na JO, Kim YJ, Kim SJ, Mo SI, et al. The usefulness of the glycosylated hemoglobin level for the diagnosis of gestational diabetes mellitus in the Korean population. Diabetes Metab J. 2015;39(6):507-11.

Soumya S, Rohilla M, Chopra S, Dutta S, Bhansali A, Parthan G, et al. HbA1c: a useful screening test for gestational diabetes mellitus. Diabetes Technol Ther. 2015;17(12):899-904.

Sujithra D., Mukherjee S, Sudha S. Glycated hemoglobin in early pregnancy as a predictor of gestational diabetes mellitus. Ind J Obstet Gynecol Res. 2018;5(3):327-30.

Ye M, Liu Y, Cao X, Yao F, Liu B, Li Y, et al. The utility of HbA1c for screening gestational diabetes mellitus and its relationship with adverse pregnancy outcomes. Diabetes Res Clin Pract. 2016;114:43-9.