Low sensitivity of serum fructosamine as a screening parameter for gestational diabetes mellitus.
Oral glucose tolerance testing (OGTT) and quantification of serum fructosamine levels were performed in 190 asymptomatic women in weeks 24-28 of pregnancy. OGTT identified 10 of the 190 women as having gestational diabetes, but serum fructosamine quantification failed to do so because none of these 10 women exhibited levels exceeding the normal limit of 2.76 mmol/l. The mean fructosamine level in this group was 1.72 +/- 0.25 mmol/l compared to 1.60 +/- 0.15 mmol/l in the other 180 women without gestational diabetes. Fructosamine was found to correlate only with postload glucose values in excess of 180 mg/dl at 2 h (r = 0.87; p = 0.01), i.e. with the highest overall glucose values, but not with fasting glucose or milder postprandial hyperglycemia of under 180 mg/dl. We conclude that quantification of fructosamine detects only the rather severe cases of gestational hyperglycemia, but is too insensitive to uncover mild asymptomatic gestational diabetes mellitus, and we do not consider fructosamine to be a useful parameter for the diagnosis of this condition.
Huter
O
O
Department of Obstetrics and Gynecology, University of Innsbruck, Austria.
Drexel
H
H
Brezinka
C
C
Soelder
E
E
Koelle
D
D
Patsch
J R
JR
D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D005069:Evaluation Studies as Topic; D005260:Female; D019270:Fructosamine; D005951:Glucose Tolerance Test; D006595:Hexosamines / Q000097:blood*; D006801:Humans; D011247:Pregnancy; D012680:Sensitivity and Specificity
D006595:Hexosamines; D019270:Fructosamine