Role of HbA1c in diagnosis of gestational diabetes mellitus

Khan, Sikandar Hayat; Manzoor, Robina; Baig, Aasyia Hanif; Tariq, Beenish; Ayub, Nadia; Sarwar, Sana; Manzoor, Sobia; Fazal, Nadeem; Nadeem, Ahmed Sameer; Nadeem, Mishal; Niazi, Najumusaqib Khan

doi:10.5455/jpma.24080

Cited by 5 publications

(4 citation statements)

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“…Participants in present study were between 15-45 years of age (mean & SD 29±5 & 31±6 years in group 1&2 respectively) which is in accordance with earlier studies [11,12,19,21].…”

Section: Discussionsupporting

confidence: 91%

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Glycated hemoglobin (HbA1c) in diagnosis of gestational diabetes mellitus

Younas,

Ali,

Khan

et al. 2024

Pak J Pathol

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Objective: To evaluate the diagnostic accuracy of glycated hemoglobin for diagnosing gestational diabetes mellitus. Material and Methodology: This cross-sectional comparative study was conducted at the Department of Chemical Pathology and Endocrinology, Reference Laboratory, Rawalpindi from June 2023 to October 2023. The study included women having gestational amenorrhea between 24th to 28th weeks, who gave informed written consent for a 75-gram oral glucose tolerance test (OGTT) at Reference Laboratory Rawalpindi. Women with diabetes, hypertension, hemoglobin< 10g/dl, on steroid treatment, with gastrointestinal or thyroid diseases were excluded. The medical history and anthropometric measurement (height, weight, body mass index (BMI) and blood pressure were recorded on a predesigned proforma. Blood sample for glucose was taken in sodium fluoride tubes and HbA1c in potassium EDTA tubes. American Diabetes Association criteria 2023 was used to diagnose gestational diabetes mellitus (GDM). Study participants were divided into two groups on basis of 75g- OGTT results; Group 1 included GDM and Group 2 Normal Glucose Tolerance (NGT). Results: A total of 100 pregnant ladies were enrolled whose ages ranged from 15-45 (mean & SD 29±5 & 31±6 years in groups 1& 2 respectively). Mean fasting plasma glucose (FPG) was 5.11±0.6 mmol/l & 4.57±0.4mmol/l, and HbA1c was 6.12%±1 & 5.26% ±0.48 in groups 1& 2 respectively. GDM was found in 19 (group 1) of 100 patients, while 81 responded normally. HbA1c at 5.6% has 84.2% sensitivity, 87.6% specificity, 61.5% PPV, 95.9% NPV and 87% diagnostic accuracy. FPG, 1hr glucose and HbA1c exhibited an Area Under Curve (AUC) by Receiver Operating Characteristic (ROC) Curve of 0.762, 0.801 & 0.894 respectively. Conclusion: HbA1c has shown higher diagnostic yield for gestational diabetes mellitus and can be used as a screening test. Keywords: Glycated hemoglobin, Oral glucose tolerance test, Gestational diabetes mellitus

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“…Participants in present study were between 15-45 years of age (mean & SD 29±5 & 31±6 years in group 1&2 respectively) which is in accordance with earlier studies [11,12,19,21].…”

Section: Discussionsupporting

confidence: 91%

“…The highest AUC for the diagnosis of GDM was exhibited by the cumulative sum of all glucose readings. They determined that modifying HbA1c levels can support in decreasing the requirements of OGTT thus advocating use of HbA1c [19].…”

Section: Discussionmentioning

confidence: 99%

Glycated hemoglobin (HbA1c) in diagnosis of gestational diabetes mellitus

Younas,

Ali,

Khan

et al. 2024

Pak J Pathol

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“…Another study by Khan et al. ( 39 ) found that the TyG index exhibited the highest AUC, surpassing HbA1c and other biomarkers, with a predictive AUC of 0.712 (95% CI: 0.631-0.793) for GDM. In our study, we observed a limited effectiveness of the TyG index in predicting GDM, with an AUC of 0.57 (95% CI: 0.50-0.62).…”

Section: Discussionmentioning

confidence: 96%

Association of triglyceride-glucose index levels with gestational diabetes mellitus in the US pregnant women: a cross-sectional study

Zeng,

Yin,

Yin

et al. 2023

Front. Endocrinol.

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ObjectiveThis investigation aimed to assess the correlation between the triglyceride-glucose (TyG) index and gestational diabetes mellitus (GDM) in pregnant women in the United States.MethodsWe calculated the TyG index utilizing data from pregnant women who participated in the National Health and Nutrition Examination Survey (NHANES) through 1999 to March 2020, and then employed multivariate logistic regression, smoothed curve fitting, and subgroup analysis to investigate the association between the TyG index and gestational diabetes during pregnancy.ResultsLogistic regression models revealed a positive association between the TyG index and GDM, remaining significant even after adjusting for all confounding variables (OR=3.43, 95% CI: 1.20-9.85, P = 0.0216). Subgroup analysis demonstrated consistent correlations and showed that there is no difference in the TyG index among first trimester subgroup. The TyG index had limited diagnostic efficacy for GDM (AUC=0.57, 95% CI: 0.50-0.63).ConclusionThe TyG index correlates positively with the GDM, however its diagnostic efficacy is limited. Further research on the TyG index as an early predictor of GDM is required.

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“…The previous meta-analyses (Umpierre et al, 2011 ; Sampath Kumar et al, 2019 ) highlighted that regular exercise could be an effective interventional strategy to improve fasting blood glucose and HbA1c for diabetic patients, which was in accordance with our results. HbA1c was a biomarker for diagnosing diabetes mellitus, and the gold standard reflecting glycemic control (Khan et al, 2020 ), which played a critical role in the treatment of diabetes. However, subgroup analysis of HbA1c and fasting blood glucose indicated that Pilates, as a supplementary treatment to medications, was not superior to the treatments used alone in diabetic patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Chen

Xia

et al. 2021

Front. Physiol.

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Objective: The benefits of Pilates for blood glucose and lipids remain unclear. The purpose of this study was to examine the effect of Pilates on their levels.Methods: Searches were conducted in five databases to identify relevant articles published until October 29, 2020. Paired reviewers independently screened the articles and extracted data from each included study. Meta-analysis was performed to assess the effects of Pilates on blood glucose and lipids. Subgroup analyses and sensitivity analyses were conducted to explore heterogeneity.Results: According to the inclusion and exclusion criteria, 15 randomized controlled trials (RCTs) comprising 587 participants were included in the study. Overall, the Pilates group (PG) had a significantly greater reduction in post-prandial blood glucose than the control group (CG) (MD = −22.25 mg/dL, 95% CI: [−28.34, 16.17] mg/dL, P < 0.00001, I2 = 0%); glycated hemoglobin (HbA1c) (MD = −0.78%, 95% CI: [−1.13, −0.42]%, P < 0.0001, I2 = 88%); total cholesterol (TC) (MD = −20.90 mg/dL, 95% CI: [−37.21, −4.60] mg/dL, P = 0.01, I2 = 84%); triglycerides (TG) (MD = −12.59 mg/dL, 95% CI: [−19.88, −5.29] mg/dL, P = 0.0007, I2 = 86%); and low density lipoprotein cholesterol (LDL-C) (MD = −12.39 mg/dL, 95% CI: [−16.82, −7.95] mg/dL, P < 0.00001, I2 = 45%) compared to CG, whereas no significant difference was detected between the two groups in fasting blood glucose (MD = −7.04 mg/dL, 95% CI: [−17.26, 3.17] mg/dL, P = 0.18, I2 = 93%), insulin (MD = −1.44 μU/mL, 95% CI: [−4.30, 1.41] μU/mL, P = 0.32, I2 = 0%); and high density lipoprotein cholesterol (HDL-C) (MD = −2.68 mg/dL, 95% CI: [−9.03, 3.67] mg/dL, P = 0.41, I2 = 89%). However, by subgroup analysis, we found that compared to the CG, PG showed no significant improvement in blood glucose and lipids levels for non-diabetics, while it presented a significantly greater decrease in post-prandial blood glucose, TC, TG, and LDL-C for diabetic patients. Notably, for diabetic patients, Pilates and medication treatments showed no significant reduction in fasting blood glucose (MD = −7.00 mg/dL, 95% CI: [−26.06, 12.06] mg/dL, P = 0.40) and HbA1c (MD = −0.23%, 95% CI: [−0.58, 0.13]%, P = 0.21, I2 = 0%) than medications treatment used alone, and Pilates combined with medications and dietary treatments presented no significant improvement in fasting blood glucose than a combination of medications and dietary treatments (MD = −10.90 mg/dL, 95% CI: [−32.35, 10.54] mg/dL, P = 0.32, I2 = 94%).Conclusions: Overall, Pilates could improve post-prandial blood glucose, fasting blood glucose, HbA1c, TG, TC, and LDL-C for diabetic patients, which could be influenced by its duration and intensity. Moreover, it had no significant effect on blood glucose and lipids for non-diabetic individuals. However, Pilates, as an adjunctive treatment to medications was not superior to medications used alone in lowering fasting blood glucose and HbA1c. Furthermore, Pilates combined with medications and dietary treatments showed no significant improvement in fasting blood glucose, whereas it had a greater reduction in post-prandial blood glucose and HbA1c for diabetic patients.Systematic Review Registration:https://osf.io/xgv6w.

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Role of HbA1c in diagnosis of gestational diabetes mellitus

Cited by 5 publications

References 0 publications

Glycated hemoglobin (HbA1c) in diagnosis of gestational diabetes mellitus

Glycated hemoglobin (HbA1c) in diagnosis of gestational diabetes mellitus

Association of triglyceride-glucose index levels with gestational diabetes mellitus in the US pregnant women: a cross-sectional study

Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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