Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2012
Clinical markers implying the need for treatment in women with gestational diabetes mellitus.
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Clayton Warren, Agarwal Neena, Wang Li, Jagasia Shubhada
Аннотация
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.
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.