Work

Role of fasting glucose and glycated hemoglobin for gestational diabetes mellitus diagnosis: A prospective study

Year: 2026

Type: article

Abstract: BACKGROUND Fasting glucose and glycated hemoglobin (HbA1c) were used to diagnose gestational diabetes during the coronavirus disease 2019 (COVID-19) pandemic. AIM To determine whether the diagnostic criteria used during the COVID-19 pandemic may play a role outside the pandemic. METHODS From May 2022 to July 2024, 354 females with an altered 50-g oral glucose tolerance test (OGTT), the usual diagnostic test (100-g OGTT), and the alternative diagnostic (A) criteria (fasting glucose ≥ 95 mg/dL and/or HbA1c ≥ 5.7%) were tested simultaneously, resulting in four different groups: OGTT+/A+ (n = 20); OGTT+/A- (n = 60); OGTT-/A+ (n = 24); and OGTT-/A- (n = 250). Groups were compared for clinical characteristics and obstetric and perinatal outcomes. RESULTS Sensitivity of the alternative criteria was 25% and specificity was 91.2%. Body mass index (BMI) was similar from the OGTT-/A+ and OGTT+/A+ groups (30.1 ± 6.3 kg/m2 and 32.7 ± 5.3 kg/m2, respectively) and significantly higher from the OGTT+/A- and OGTT-/A- groups (26.8 ± 5.1 kg/m2 and 25.6 ± 5.0 kg/m2, respectively). The between-group differences were similar for the respective rates of large for gestational age (LGA) infants (OGTT+/A+: 38.9%, OGTT+/A-: 11.8%, OGTT-/A+: 29.4%, OGTT-/A-: 12.4%; P = 0.028). In the regression analysis a history of macrosomia [odds ratio (OR) = 7.948, 95% confidence interval (95%CI): 2.269-27.842; P = 0.001] and higher pregestational BMI (OR = 1.069, 95%CI: 1.002-1.140; P = 0.042) independently increased the risk of LGA. CONCLUSION Despite insufficient validity to replace the OGTT, alternative criteria identify a group of patients with a higher risk profile and adverse perinatal outcomes who could benefit for health interventions.

Source: World Journal of Diabetes

DOI: 10.4239/wjd.v17.i1.112882