title: Clinical markers implying the need for treatment in women with gestational diabetes mellitus.
abstract: OBJECTIVE
  To assess the association of the point-of-care hemoglobin A1c (POC A1C), fasting blood glucose (FBG), and BMI with fetal macrosomia and the need for medication in women with gestational diabetes (GDM).
  
  
  METHODS
  POC A1C, FBG, and BMI values at GDM diagnosis and fetal weight at delivery were obtained for women identified from a prospective patient registry. These outcomes were compared between women who did not require medication for GDM and women who did require medication.
  
  
  RESULTS
  Mean values of POC A1C, FBG, and BMI in 67 patients who required medication were higher than those in 71 patients who did not require medication (POC A1C: 5.72 ± 0.45% vs 5.35 ± 0.46% [P<.001]; FBG: 97.4 ± 12.3 mg/dL vs 86.4 ± 9.5 mg/dL [P<.001]; BMI: 35.4 ± 6.4 kg/m2 vs 30.4 ± 6.2 kg/m(2) [P<.001]). There was a modest correlation between POC A1C and FBG (Spearman rho 0.4, P<.001) and between POC A1C and BMI (Spearman rho 0.366, P<.001). Maternal POC A1C was not correlated with fetal weight at delivery (Spearman rho -0.010, P = .915).
  
  
  CONCLUSIONS
  Higher POC A1C, FBG, and BMI values were associated with the need for medication in women with GDM. The use of clinical markers to assess glycemic control sooner in pregnancy may lead to the earlier identification of women at risk for GDM and earlier intervention to decrease the risk for complications.
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
authors.forename: Warren
authors.initials: W
authors.lastname: Clayton
authors.forename: Neena
authors.initials: N
authors.lastname: Agarwal
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Shubhada
authors.initials: S
authors.lastname: Jagasia
mesh_terms: D000328:Adult; D015415:Biomarkers; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications; D020567:Fetal Weight / Q000502:physiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D019095:Point-of-Care Systems; D011247:Pregnancy; D012042:Registries
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin