A1C in Gestational Diabetes Mellitus in Asian Indian Women
- Vijayam Balaji, MD,
- Balji S. Madhuri, MB,
- Srinivasan Ashalatha, MB,
- Suganthi Sheela, MB,
- Suresh S, MB and
- Veerasamy Seshiah, MD
- From the Dr. V. Seshiah Diabetes Care and Research Institute, Chennai, India
- Address correspondence and reprint requests to Prof. V. Seshiah, MD, Dr. V. Seshiah Diabetes Care and Research Institute, 31A, Ormes Road, Kilpauk, Chennai 600 010, Tamilnadu, India. E-mail: vseshiah{at}gmail.com
Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy. The current recommendation is to perform screening test between 24 and 26 weeks of gestation, although there are reports claiming that between 40 and 66% of women with GDM could be detected during early pregnancy (1,2). The policy of screening in the third trimester has resulted in a significant number of pregnant women delivering big babies, despite good glycemic control (3), whereas an early screening for glucose intolerance and care has resulted in the reduction of some of the hyperglycemia-related complications (4). Pregnant women diagnosed as having glucose intolerance in the first trimester are likely to have unrecognized type 2 diabetes before pregnancy (pre-GDM) or pregnancy-induced glucose intolerance during pregnancy (GDM) (5,6). These two clinical situations need to be delineated, as pre-GDM women are likely to have more morbidity and require immediate attention. Hence, we undertook this study to find out whether estimation of A1C levels, along with oral glucose tolerance tests (OGTTs), would help us to distinguish between these two groups, as A1C is directly related to the average concentration of blood glucose in the previous weeks. We also wanted to assess the A1C level during normal pregnancy in our population.
RESEARCH DESIGN AND METHODS—
We screened 507 consecutive pregnant women for diabetes and pregnancy who were attending our referral center, irrespective of trimesters, with a 75-g OGTT. Women with a history of type 2 diabetes and GDM were excluded from this study. Blood samples were drawn at fasting and at 1 and 2 h for estimating plasma glucose. The plasma glucose …
