Hemoglobin A1C inadequate for postpartum diabetes screening

Hemoglobin A1C inadequate for postpartum diabetes screening
For postpartum women who have had gestational diabetes mellitus, the hemoglobin A1c test criteria alone or in combination with fasting glucose test criteria does not provide sensitive and specific diagnosis of abnormal carbohydrate metabolism compared with the gold-standard oral glucose tolerance test, according to a study published online June 11 in Diabetes Care.

(HealthDay) -- For postpartum women who have had gestational diabetes mellitus (GDM), the hemoglobin A1c (A1C) test criteria alone or in combination with fasting glucose test criteria does not provide sensitive and specific diagnosis of abnormal carbohydrate metabolism compared with the gold-standard oral glucose tolerance test (OGTT), according to a study published online June 11 in Diabetes Care.

María José Picón, M.D., Ph.D., of the Virgen de la Victoria University Hospital in Malaga, Spain, and colleagues measured the sensitivity and positive predictive value (PPV) of the A1C test, with or without the fasting glucose test, compared with the OGTT in 231 postpartum women with prior GDM one year after delivery.

The researchers found that, based on the OGTT, A1C test, fasting glucose test, and A1C-fasting glucose test criteria, the prevalence of abnormal was 45.89, 19.05, 38.10, and 46.75 percent, respectively. Compared with the OGTT, the A1C test had a sensitivity and PPV of 22.64 and 54.55 percent, respectively; while the fasting glucose criterion had a sensitivity and PPV of 83.02 and 100 percent, respectively. Using both together, the sensitivity and PPV were 83.02 and 81.48 percent, respectively; and these criteria classified 18 women with normal carbohydrate metabolism as having abnormal carbohydrate metabolism.

"In summary, the A1C test significantly underdiagnosed carbohydrate metabolism disorders in women who had had GDM," the authors write.

More information: Abstract
Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

New NIH fact sheet explains test for diabetes, prediabetes

Jan 27, 2012

A new fact sheet from the National Institutes of Health explains the A1C test, a widely used and important test to diagnose type 2 diabetes and prediabetes, and to monitor blood glucose levels of people with type 1 and type ...

Gestational diabetes, obesity impact pregnancy outcomes

Mar 02, 2012

(HealthDay) -- Women with gestational diabetes mellitus (GDM) who are obese have significantly higher odds of adverse pregnancy outcomes, according to findings from the multinational Hyperglycemia and Adverse ...

Recommended for you

Economic burden of prediabetes up 74 percent over five years

6 hours ago

The economic burden of diabetes in America continues to climb, exceeding more than $322 billion in excess medical costs and lost productivity in 2012, or more than $1,000 for every American, according to a study being published ...

Gynoid fat resists metabolic risks of obesity

Nov 19, 2014

(HealthDay)—The differences in the developmental profiles of upper-body and lower-body fat depots may explain their opposing associations with obesity-related metabolic disease, according to research published ...

Treating diabetes one meal at a time

Nov 19, 2014

Recent estimates project that as many as one in three American adults will have diabetes in 2050. The American Diabetes Association observes November as American Diabetes Month, and this year's theme is America ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.