Glucose Tolerance versus HbA1c Results as Depictive of Gestational Diabetes Mellitus

• Published in: Journal of the College of Physicians and Surgeons--Pakistan Vol. 29; no. 4; pp. 333 - 336
• Main Authors: Khan, Sikandar Hayat, Manzoor, Robina, Baig, Aasyia Hanif, Sobia, Farah, Fazal, Nadeem, Niazi, Najmusaqib Khan
• Format: Journal Article
• Language: English
• Published: Pakistan College of Physicians and Surgeons Pakistan 01-04-2019
• Subjects: Analysis; Gestational diabetes; Glucose; Glucose tolerance test; Glycosylated hemoglobin; Pregnant women; Pakistan
• ISSN: 1022-386X; 1681-7168
• DOI: 10.29271/jcpsp.2019.04.333

To evaluate glucose tolerance patterns in pregnant ladies undergoing 2-hour oral glucose tolerance test (OGTT) for comparing fasting, 1-hour, 2-hour post-glucose load results, HbA1c, sum of all glucose readings with and without gestational diabetes mellitus (GDM) using International Association of the Diabetes and Pregnancy Study Group (IADPSG) diagnostic criteria.
Cross-sectional analysis.
PNS Hafeez, Naval Hospital, Islamabad, from January 2016 to July 2017.
For 280 evaluated subjects reporting in mid-pregnancy for OGTT, results were segregated into four groups based upon comparison of 2-hour glucose result with 1-hour glucose. Group-1 2-hour results drop being >2.0 mmol/L than1-hour results, group-2 with 2-hour result between <2.0 to >0.5 mmol/L than peak at 1-hour, and group-3 with either 2-hour glucose drop being <0.5mmol/L or >1-hour results. Further, the ROC curve analysis was performed to compare the AUC for fasting plasma glucose, 1-hour post OGTT result, 2-hour post-OGTT result, factor additive of all OGTT readings and HbA1c.
There was a progressive rise in HbA1c from group-1 to group-3 (p<0.001). Area under curve (AUC) for various diagnostic parameters for diagnosing GDM for additive value of all glucose results was 0.962 (95% CI: 0.935-0.988), 0.881 (95% CI: 0.818-0944) for plasma glucose at 2-hour, for plasma glucose at 1-hour 0.898 (95% CI: 0.0.842-0.954), 0.831 (95% CI: 0.0.762-0.901) for fasting plasma glucose and 0.668 (95% CI: 0.0.578-0.759) for HbA1c (p<0.001).
Pregnant ladies demonstrating poor tolerance to glucose at 2-hour were observed to have higher HbA1c levels.