Glucose Tolerance versus HbA1c Results as       Depictive of Gestational Diabetes Mellitus

Khan, Sikandar Hayat; Manzoor, Robina; Baig, Aasyia Hanif; Sobia, Farah; Fazal, Nadeem; Niazi, Najmusaqib Khan

doi:10.29271/jcpsp.2019.04.333

Cited by 4 publications

(7 citation statements)

References 18 publications

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“…Comparison of glucose tolerance patterns of pregnant women subjected to 2-H OGTT at fasting, 1-H, 2-H post-glucose load, HbA1c, the sum of all glucose readings among pregnant women with and without GDM using IADPSG criteria shows that the mean PBG at fasting, at 1-hour and 2-hour for both diagnosed and non-diagnosed GDM were; 5.37±1.59 vs. 4.10 ±0.53; 10.67±3.22 vs. 6.71±1.50; and 8.88±3.41 vs. 5.57±1.10 respectively and when adding all these glucose estimation values for diagnosing of GDM produced and ROC with AUC = 0.962 (95% CI: 0.935-0.988) however, AUC for HbA1c = 0.668. The study also reported a high level of HbA1c in subjects with delayed 2-hour post-glucose load peak (Khan 2019) [25].…”

Section: Nambiar (2011) [48]mentioning

confidence: 81%

“…Rajput et al, 2012 [24] evaluated the efficacy of HbA1c in combination with OGTT using criteria ADA and IADPSG criteria and reported good sensitivity and specificity at various cut-offs. Similarly, Khan 2019 [25] evaluated glucose tolerance patterns of pregnant women subjected to 2-H OGTT for comparing fasting, 1-H, 2-H post-glucose load results, HbA1c and reported that a combined glucose estimation of these values produced an AUC of 0.962 (95% CI: 0.935-0.988). However, HbA1c as single parameters yields a comparatively low diagnostic accuracy.…”

Section: Gestational Diabetesmentioning

confidence: 99%

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Generating evidence on screening, diagnosis and management of non-communicable diseases during pregnancy; a scoping review of current gap and practice in India with a comparison of Asian context

et al. 2021

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Background Children born to high-risk pregnancies are more likely to experience adverse health outcomes later in life. As estimated, 15% of all pregnancies are at risk of various life-threatening conditions leading to adverse maternal and foetal outcomes. Millennium Development Goal resulted in the global reduction of maternal death from 390,000 to 275000 in 1990–2015). Similarly, to keep this momentum, the current United Nations Sustainable Development Goal (SDG: 3.1) aims at reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030, and this can be achieved by addressing high-risk pregnancy contributing to significant mortality and morbidity. In India, gestational diabetes, gestational hypertension, and gestational hypothyroidism were identified as factors contributing to the high-risk pregnancy. This review summarises the commonly used approach for screening, diagnosis, and management of these conditions in the Asian population. It draws a comparison with the current protocols and guidelines in the Indian setting. Methods Electronic search in PubMed and Google Scholar, reference snowballing, and review of current guidelines and protocols were done between January 2010 to October 2019. Published studies reporting Screening, diagnosis, and management of these conditions were included. Articles selected were then screened, appraised for quality, extract relevant data, and synthesised. Results Screening, diagnosis, and management of these three conditions vary and no single universally accepted criteria for diagnosis and management exist to date. In India, national guidelines available have not been evaluated for feasibility of implementation at the community level. There are no national guidelines for PIH diagnosis and management despite the increasing burden and contribution to maternal and perinatal morbidity and mortality. Criteria for diagnosis and management of gestational diabetes, gestational hypertension, and gestational hypothyroidism varies but overall early screening for predicting risk, as reported from majority of the articles, were effective in minimizing maternal and foetal outcome. Conclusion Existing National guidelines for Screening, Diagnosis, and Management of Gestational Diabetes Mellitus (2018) and Gestational Hypothyroidism (2014) need to be contextualized and modified based on the need of the local population for effective treatment. Findings from this review show that early screening for predicting risk to be an effective preventive strategy. However, reports related to a definitive diagnosis and medical management were heterogeneous.

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Section: Nambiar (2011) [48]mentioning

confidence: 81%

Section: Gestational Diabetesmentioning

confidence: 99%

Generating evidence on screening, diagnosis and management of non-communicable diseases during pregnancy; a scoping review of current gap and practice in India with a comparison of Asian context

et al. 2021

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“…Another research reported statistical significant rise in fasting insulin and HOM-IR formula (p < 0.05), but no statistical significant difference in fasting blood glucose in cases with SCH compared to healthy controls [20]. Research assessed the IR and glucose levels in subjects with SCH and demonstrated that measures of IR including serum fasting insulin and HOMA-IR rise from euthyroidism to subjects having SCH [21].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Cardiovascular Risk Factors and Insulin Resistance in Patients with Subclinical Hypothyroidism

Shafeek

Sawy

Kabbash

et al. 2023

JAMMR

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Background: Overt hypothyroidism is associated with Insulin resistance (IR), accelerated arteriosclerosis and cardiovascular disease (CVD). Although SCH (SCH) is also associated with CVD risk remains controversial. Objective: The present research aimed to assess risk factors for CVD and IR in SCH cases. Methods: Case control study was carried out on 90 participants. The research included two groups; group one included 45 SCH cases and group two (controls) included 45 healthy volunteers. We assessed common lipid variables, fasting blood glucose, fasting insulin, HOMA IR, thyroid profile for all participants. Results: There was highly significant rise in anthropometric measures including body weight, BMI and waist circumference in SCH than controls (P value = <0.001). There was significant rise in systolic and diastolic blood pressure (BP) in SCH than controls (P value = <0.001, 0.001). There was significant rise in triglyceride level, total cholesterol and LDL-C in SCH in comparison to controls (P value = 0.019, <0.001, <0.001) and significant decline in HDL-C in SCH in comparison to controls (P value = 0.011). There was significant positive correlation between TSH level and anthropometric measures, BP, indices of IR, total cholesterol, triglycerides and LDL-C, but significant negative correlation with HDL-C. Conclusion: Our findings suggest that SCH might increase the risk for CVD which explain the needs for early detection and treatment of such individuals.

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“…After the blood collection, 75g glucose was taken orally, and venous blood collection was conducted again 1 hour post and 2 hours post, respectively. The diagnosis of GDM was made based on the criteria of the International Association of Diabetes and Pregnancy Study Group 30 when any of the following conditions was met: fasting glucose ≥ 5.1 mmol/L (92 mg/dL), or 1-h post glucose ≥ 10.0 mmol/L (180 mg/dL), or 2-h post glucose ≥ 8.5 mmol/L (153 mg/dL).The blood glucose area under the curve (AUC), an effective indicator to reflect the comprehensive level of fasting, 1-h post and 2-h post blood glucose, 31 was also calculated for the participants.…”

Section: Measurement Of Blood Glucose and Diagnosis Of Gdmmentioning

confidence: 99%

Sleep Quality is an Independent Predictor of Blood Glucose and Gestational Diabetes Mellitus: A Longitudinal Study of 4550 Chinese Women

Chen¹,

He²,

Zeng³

et al. 2022

NSS

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To investigate whether pregnant women's subjective sleep quality during the first trimester independently predicted blood glucose and gestational diabetes mellitus (GDM). Methods: A total of 4550 pregnant women in the first trimester were enrolled in Chongqing Health Center for Women and Children, China, from January to October 2020.The Pittsburgh Sleep Quality Index (PSQI) was used to measure subjective sleep quality. Depression symptoms and anxiety were measured with the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7). Oral glucose tolerance tests (OGTT) and blood glucose area under the curve (AUC) were used for estimation of blood glucose and diagnosis of GDM during the second trimester. Linear, mixed model, and logistic regression were used to analyze the association between PSQI and blood glucose as well as GDM. Results: 946/4550 were diagnosed with GDM (20.8%). In the mixed model analysis, the blood glucose level of the highest-scoring group (PSQI score = 18) was 1.94 (95% CI: 0.45~3.43, P = 0.011) mmol/L higher than that of the lowest-scoring group (PSQI score = 0). After adjusting for potential confounders, a one-point PSQI score increase was associated with a 0.014 (95% CI: 0.001~0.027, P = 0.039) mmol/L increase in blood glucose level. Blood glucose AUC was also positively associated with PSQI scores (β = 0.034, 95% CI: 0.003~0.064, P = 0.030). The results for the logistic regression model showed that PSQI was marginal positively correlated with GDM (OR = 1.146, 95% CI: 0.995~1.321, P = 0.059) when age and BMI were not controlled for. When investigating the association between PSQI and the GDM-diagnosed time window, the 1-h diagnosed GDM had a borderline positive correlation with PSQI (OR = 1.182, 95% CI: 0.993~1.405, P = 0.060). Conclusion:Sleep quality during the first trimester may be a risk factor for elevated blood glucose and GDM later in gestation.

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Glucose Tolerance versus HbA1c Results as Depictive of Gestational Diabetes Mellitus

Cited by 4 publications

References 18 publications

Generating evidence on screening, diagnosis and management of non-communicable diseases during pregnancy; a scoping review of current gap and practice in India with a comparison of Asian context

Generating evidence on screening, diagnosis and management of non-communicable diseases during pregnancy; a scoping review of current gap and practice in India with a comparison of Asian context

Assessment of Cardiovascular Risk Factors and Insulin Resistance in Patients with Subclinical Hypothyroidism

Sleep Quality is an Independent Predictor of Blood Glucose and Gestational Diabetes Mellitus: A Longitudinal Study of 4550 Chinese Women

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