title: An evaluation of fructosamine estimation in screening for gestational diabetes mellitus.
abstract: Although persuasive arguments against routine screening for gestational diabetes mellitus (GDM) have been made, it is widely but not universally performed as a part of antenatal care. There is no international agreement on methods or criteria used for screening (or for diagnosis), and administered glucose-load methods have significant practical difficulties in a busy antenatal clinic setting. However, recent evidence supports the concept of an increased level of importance being given to a diagnosis of GDM, with interest in the fetal and neonatal origins of adult disease being added to the short-term obstetric and fetal concern during pregnancy. A second generation fructosamine test, corrected for total protein, has been evaluated as a practical alternative to glucose screening for GDM in a busy, multi-ethnic antenatal clinic. This achieved a 79.4% sensitivity and a 77.3% specificity for a diagnosis of GDM confirmed by a glucose tolerance test using Carpenter's modified criteria. In view of the organizational simplicity of this sample/test requirement, a wider evaluation is suggested together with a re-evaluation of clinical outcome criteria rather than blood glucose levels alone.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
authors.forename: P F
authors.initials: PF
authors.lastname: Hughes
authors.forename: M
authors.initials: M
authors.lastname: Agarwal
authors.forename: P
authors.initials: P
authors.lastname: Newman
authors.forename: J
authors.initials: J
authors.lastname: Morrison
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control; D005215:Fasting; D005260:Female; D019270:Fructosamine; D005951:Glucose Tolerance Test; D006595:Hexosamines / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening; D011247:Pregnancy; D011295:Prenatal Care; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006595:Hexosamines; D019270:Fructosamine