An evaluation of glycosylated hemoglobin measurement by a colorimetric method as a screening test for gestational diabetes mellitus.
To assess the potential value of glycosylated hemoglobin measurement (HbA1) in screening for gestational diabetes mellitus (GDM), HbA1 by a colorimetric method, plasma glucose level 1 hr after 50 g oral glucose loading, and 3-hr 100 g oral glucose tolerance test (3-hr OGTT) were performed in 334 pregnant women at Ramathibodi Hospital. These subjects carried high risk factors of GDM. Gestational ages varied from 24 to 38 wks. Twenty-four cases were diabetic (7.2%) by O'Sullivan and Mahan's criteria (1964). As a screening test to select subjects for 3-hr OGTT, plasma glucose level 1 hr after 50 g oral glucose load (plasma glucose level 7.8 mmol/L and above) has sensitivity: 87.50 per cent, specificity: 64.19 per cent. HbA1 level of 5.60 per cent (upper 95% confidence limit of the mean) and above yield sensitivity: 66.67 per cent, specificity: 61.29 per cent. Thus, glycosylated hemoglobin measurement as a screening test for GDM is not as effective as the conventional 50 g oral glucose loading test.
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Puavilai
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Chanprasertyotin
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Jirapinyo
D000328:Adult; D003124:Colorimetry; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening; D011237:Predictive Value of Tests; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000517:prevention & control*; D011295:Prenatal Care; D011446:Prospective Studies; D013858:Thiobarbiturates
D006442:Glycated Hemoglobin; D013858:Thiobarbiturates; C029684:thiobarbituric acid