HbA1c as a predictor of diabetes after gestational diabetes mellitus
Claesson, Rickard LU ; Ignell, Claes LU
; Shaat, Nael
LU
and Berntorp, Kerstin
LU
(2017)
In Primary Care Diabetes
11(1).
p.46-51
- Abstract
Aim We wanted to investigate third-trimester HbA1c as a predictor of diabetes after gestational diabetes mellitus (GDM). Methods Women with GDM were followed up prospectively for five years from pregnancy to detect the development of diabetes. The ability of HbA1c to predict diabetes was evaluated with receiver-operating characteristic (ROC) curves and logistic regression analysis. Results By five years, 73 of 196 women had been diagnosed with diabetes. An optimal cut-off point for HbA1c of 36 mmol/mol (5.4%) could predict diabetes with 45% sensitivity and 92% specificity. For HbA1c ≥39 mmol/mol (≥5.7%), sensitivity, specificity, and positive predictive value were 30%, 97%, and 91%, respectively. In logistic regression analysis,... (More)
Aim We wanted to investigate third-trimester HbA1c as a predictor of diabetes after gestational diabetes mellitus (GDM). Methods Women with GDM were followed up prospectively for five years from pregnancy to detect the development of diabetes. The ability of HbA1c to predict diabetes was evaluated with receiver-operating characteristic (ROC) curves and logistic regression analysis. Results By five years, 73 of 196 women had been diagnosed with diabetes. An optimal cut-off point for HbA1c of 36 mmol/mol (5.4%) could predict diabetes with 45% sensitivity and 92% specificity. For HbA1c ≥39 mmol/mol (≥5.7%), sensitivity, specificity, and positive predictive value were 30%, 97%, and 91%, respectively. In logistic regression analysis, adjusting for the diagnostic glucose concentration during pregnancy, HbA1c levels in the upper quartile (≥36 mmol/mol) were associated with a 5.5-fold increased risk of diabetes. Conclusion Third-trimester HbA1c levels in the pre-diabetes range revealed women with post-partum diabetes with high specificity and high positive predictive value. HbA1c testing could be used as a strategy to select high-risk women for lifestyle interventions aimed at prevention of diabetes starting during pregnancy. The results should encourage further validation in other populations using new diagnostic criteria for GDM.
(Less)
- author
- Claesson, Rickard
LU
; Ignell, Claes
LU
; Shaat, Nael
LU
and Berntorp, Kerstin
LU
- organization
- publishing date
- 2017-02-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Gestational diabetes, HbA1c, OGTT, Post-partum diabetes, Prediction
- in
- Primary Care Diabetes
- volume
- 11
- issue
- 1
- pages
- 6 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:27692850
- wos:000392679200006
- scopus:85007579601
- ISSN
- 1751-9918
- DOI
- 10.1016/j.pcd.2016.09.002
- language
- English
- LU publication?
- yes
- id
- 48969c11-aee8-4e91-8432-6c75b151a780
- date added to LUP
- 2017-01-13 12:51:21
- date last changed
- 2024-04-05 14:29:01
@article{48969c11-aee8-4e91-8432-6c75b151a780,
abstract = {{<p>Aim We wanted to investigate third-trimester HbA1c as a predictor of diabetes after gestational diabetes mellitus (GDM). Methods Women with GDM were followed up prospectively for five years from pregnancy to detect the development of diabetes. The ability of HbA1c to predict diabetes was evaluated with receiver-operating characteristic (ROC) curves and logistic regression analysis. Results By five years, 73 of 196 women had been diagnosed with diabetes. An optimal cut-off point for HbA1c of 36 mmol/mol (5.4%) could predict diabetes with 45% sensitivity and 92% specificity. For HbA1c ≥39 mmol/mol (≥5.7%), sensitivity, specificity, and positive predictive value were 30%, 97%, and 91%, respectively. In logistic regression analysis, adjusting for the diagnostic glucose concentration during pregnancy, HbA1c levels in the upper quartile (≥36 mmol/mol) were associated with a 5.5-fold increased risk of diabetes. Conclusion Third-trimester HbA1c levels in the pre-diabetes range revealed women with post-partum diabetes with high specificity and high positive predictive value. HbA1c testing could be used as a strategy to select high-risk women for lifestyle interventions aimed at prevention of diabetes starting during pregnancy. The results should encourage further validation in other populations using new diagnostic criteria for GDM.</p>}},
author = {{Claesson, Rickard and Ignell, Claes and Shaat, Nael and Berntorp, Kerstin}},
issn = {{1751-9918}},
keywords = {{Gestational diabetes; HbA1c; OGTT; Post-partum diabetes; Prediction}},
language = {{eng}},
month = {{02}},
number = {{1}},
pages = {{46--51}},
publisher = {{Elsevier}},
series = {{Primary Care Diabetes}},
title = {{HbA1c as a predictor of diabetes after gestational diabetes mellitus}},
url = {{http://dx.doi.org/10.1016/j.pcd.2016.09.002}},
doi = {{10.1016/j.pcd.2016.09.002}},
volume = {{11}},
year = {{2017}},
}