title: The usefulness of HbA1c in postpartum reclassification of gestational diabetes.
abstract: To investigate the role of HbA1c in postpartum reclassification of gestational diabetes (GDM) we studied 364 women with GDM attending the postpartum reclassification assessment of their glucose tolerance status. A 75-g oral glucose tolerance test (OGTT) was performed and HbA1c was determined. Diabetes was diagnosed in 12 (3.3%), 7 (1.9%) and 2 (0.6%) women according to the fasting plasma glucose (FPG) and/or the 2-hour OGTT, the FPG alone and HbA1c levels, respectively. The sensitivity and specificity for HbA1c to diagnose diabetes was 16.7% and 100%, respectively, for FPG and OGTT criteria. The combination of a cutoff value of 5.5% for HbA1c and FPG allowed us to identify 95.1% of women with any kind of glucose intolerance. We conclude that in the early postpartum period, the cutoff of 6.5% for HbA1c alone has low sensitivity for the diagnosis of diabetes compared with OGTT, but the combination of FPG and HbA1c at a lower cutoff value is very useful to identify women with any kind of glucose intolerance.
authors.affiliation: University Hospital Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain. amegia.hj23.ics@gencat.cat
authors.forename: A
authors.initials: A
authors.lastname: Megia
authors.forename: S
authors.initials: S
authors.lastname: Näf
authors.forename: L
authors.initials: L
authors.lastname: Herranz
authors.forename: N
authors.initials: N
authors.lastname: Serrat
authors.forename: R E
authors.initials: RE
authors.lastname: Yañez
authors.forename: I
authors.initials: I
authors.lastname: Simón
authors.forename: J
authors.initials: J
authors.lastname: Vendrell
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D016640:Diabetes, Gestational; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000097:blood / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human