Diagnostic value of glycemic markers HbA1c, 1,5-anhydroglucitol and glycated albumin in evaluating gestational diabetes mellitus

Saglam, Baris; Uysal, Sezer; Sozdinler, Sadik; Doğan, Ömer Erbil; Onvural, Banu

doi:10.1177/2042018817742580

Cited by 17 publications

(11 citation statements)

References 35 publications

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“…Zhu et al [22] reported that the AUC values were 0.726 for FPG and only 0.542 for GlyA in the second trimester. Similar observation was made by Saglam et al [25], with the AUC of GlyA being 0.550 in the GDM diagnosis. In our study, we also found a higher diagnostic value of FPG (AUC = 0.721) than that of GlyA (AUC = 0.509) during the 24-28 weeks of gestation.…”

Section: Discussionsupporting

confidence: 88%

Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

Dong

Zhai

Wang

et al. 2020

BMC Pregnancy Childbirth

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Background: Many efforts have been focused on the alternative glycemic marker glycated albumin (GlyA) and its application in pregnancy during which profound physiological changes take place. Our objective was to determine the reference intervals (RIs) of GlyA in healthy Chinese pregnant women and to assess the predictive value of serum GlyA in adverse pregnancy outcomes. Methods: Totally 421 healthy subjects including 137 in the first trimester, 152 in the second trimester, and 132 in the third trimester were enrolled from March to July 2019, for the purpose of establishing the trimester-specific RIs of GlyA. In addition, 67 pregnant women diagnosed with GDM were enrolled at 24-28 weeks of gestation. The diagnostic value of GlyA for GDM patients was evaluated and compared with that of fasting plasma glucose (FPG) at 24-28 weeks of gestation. The association between GlyA in the late pregnancy and the adverse pregnancy outcomes was analyzed with the data collected from January to June 2018 at our hospital. Results: The estimated RIs of GlyA in present study were 11.26-15.10%, 10.04-13.50%, and 9.76-13.09% in the first, second, and third trimesters respectively. The areas under receiver operating characteristic (ROC) curves were 0.503 for GlyA and 0.705 for FPG. More importantly, the GlyA level in the third trimester was not more elevated in the patients with adverse pregnancy outcomes including large for gestational age (LGA), preterm delivery, hypertension and preeclampsia (PE). The exception was made with the GDM patients who suffered from postpartum hemorrhage and had significantly higher GlyA levels than the control group. Conclusions: Our results showed that the GlyA was continuously decreased as the gestational age went up. The GlyA testing has limited value in diagnosing GDM and predicting adverse pregnancy outcomes.

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Section: Discussionsupporting

confidence: 88%

Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

Dong

Zhai

Wang

et al. 2020

BMC Pregnancy Childbirth

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“…It was shown that 1,5‐AG is more sensitive to reflect postprandial blood glucose than HbA1c and glycated albumin, and to detect glucose fluctuation in the shorter term. In some recent studies, 1,5‐AG was used as a screening tool for type 2 diabetes and gestational diabetes mellitus. Unfortunately, in the present study, in group D, which showed significant changes in the proportions of patients achieving HbA1c <7%, 1,5‐AG levels did not increase synchronously.…”

Section: Discussioncontrasting

confidence: 76%

Effects of mobile phone application combined with or without self‐monitoring of blood glucose on glycemic control in patients with diabetes: A randomized controlled trial

Yuan

Yan

et al. 2019

J of Diabetes Invest

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Aims/Introduction There is potential for mobile applications to deliver new self‐management interventions for chronic disease, especially in diabetes. The aim of the present study was to evaluate the effects of a mobile phone application (MPA) combined with or without self‐monitoring of blood glucose (SMBG) on glycemic control in patients with diabetes. Materials and Methods The study was a 24‐week period, four‐arm parallel group, non‐blinded, randomized trial. A total of 185 patients with mean age of 52 years were randomized to group A (no MPA and no SMBG), group B (SMBG only), group C (MPA only) and group D (both MPA and SMBG were used). Changes in glycated hemoglobin (HbA1c), fasting plasma glucose and 1,5‐anhydroglucitol from baseline to week 24 were analyzed. Results At 24 weeks, the HbA1c levels in patients of all groups decreased significantly from baseline. There were significant differences in the proportions of patients that achieved HbA1c <7% between groups, especially in group C and group D, compared with group A at week 24 (60.4%, 62.2% vs 25.5%, all P < 0.05). 1,5‐Anhydroglucitol changes were obvious in group A and group C at week 24 from baseline (all P < 0.05 within groups). Factorial analysis of anova showed that MPA intervention was the main effective factor for HbA1c change (F = 4.59, P = 0.034), and there was no effect on HbA1c change for SMBG intervention (P = 0.975). Conclusions Implementation of the MPA, Diabetes‐Carer, is effective in improving the proportion of HbA1c <7% in patients with type 2 diabetes.

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“…Zhu et al [20] reported that the AUC values were 0.726 for FPG and only 0.542 for GA in the second trimester. Similarly, observation was made by Saglam et al [23] with the AUC of GA being 0.550 in the GDM diagnosis. In our study, we also found a higher diagnostic value of FPG (AUC = 0.705) than that of GA (AUC = 0.503) during the 24-28 weeks of gestation.…”

Section: Discussionsupporting

confidence: 71%

Glycated Albumin in Pregnancy: Reference Intervals Establishment and Its Predictive Value in Adverse Pregnant Outcomes

Dong

Zhai

Wang

et al. 2019

Preprint

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Background As one of the most common pregnant complications, the gestational diabetes mellitus (GDM) is associated with significant adverse pregnant outcomes and it is crucial to accurately monitor the glycemic states of GDM patients. The HbA1c which is a traditional long-term glycemic marker used in diabetic patients, is not recommended in GDM patients during pregnancy. Recently, many efforts have been focused on the alternative marker glycated albumin (GA) and its application in pregnancy during which profound physiological changes take place. Our objective was to determine the reference intervals (RIs) of GA in healthy Chinese pregnant women and to assess the predictive value of serum GA in adverse pregnant outcomes. Methods Totally 479 healthy subjects including 153 in the first trimester, 174 in the second trimester, and 152 in the third trimester were enrolled from March to July 2019, for the purpose of establishing the trimester-specific RIs of GA. The diagnostic value of GA for GDM patients was evaluated and compared with that of fasting plasma glucose (FPG) at 24-28 weeks of gestation. The association between GA in the late pregnancy and the adverse pregnant outcomes was analyzed retrospectively with the data collected from January to June 2018 at our hospital. Results The estimated RIs of GA in present study were 10.87-15.09 %, 10.04-13.50 %, and 9.78-13.03 % in the first, second, and third trimesters respectively. The areas under receiver operating characteristic (ROC) curves were 0.503 for GA and 0.705 for FPG. More importantly, the GA levels of the third trimester did not show significant changes in women with large-for-date birth weight, preterm delivery, postpartum hemorrhage or hypertension when compared in women with normal pregnancy outcomes. The exception was that the GDM patients who developed preeclampsia did have a lower GA level in their late pregnancy. Conclusions Our results show that the GA was continuously decreased as the gestational age went up. It has limited value in diagnosing GDM and predicting adverse pregnancy outcomes.

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Diagnostic value of glycemic markers HbA1c, 1,5-anhydroglucitol and glycated albumin in evaluating gestational diabetes mellitus

Abstract: HbA1c and 1,5-AG alone does not have sufficient diagnostic accuracy to diagnose GDM. 1,5-AG values were correlated with post-load glucose values in pregnant women so will improve the GDM management and be useful to predict complications.

Cited by 17 publications

References 35 publications

Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

Glycated albumin in pregnancy: reference intervals establishment and its predictive value in adverse pregnancy outcomes

Effects of mobile phone application combined with or without self‐monitoring of blood glucose on glycemic control in patients with diabetes: A randomized controlled trial

Glycated Albumin in Pregnancy: Reference Intervals Establishment and Its Predictive Value in Adverse Pregnant Outcomes

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