Increased HbA1c and HOMA-IR may predict risk of gestational diabetes early in pregnancy

Written By :  Aditi
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2023-04-27 05:45 GMT   |   Update On 2023-04-27 10:50 GMT
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China: According to a study published in Diabetes Research and Clinical Practice, researchers have concluded that there is an increased incidence of gestational diabetes mellitus (GDM) with increasing HbA1c and HOMA-IR.

They also mentioned that gestational diabetes risk is higher when both HbA1c and HOMA-IR are higher. The study has addressed the need to identify high-risk women for gestational diabetes mellitus early in pregnancy so that timely interventions could be provided.

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Researchers in the present study investigated the association of glycated haemoglobin (HbA1c) and homeostasis model assessment insulin resistance (HOMA-IR) with gestational diabetes mellitus (GDM) risk. They included pregnant women with HbA1c, fasting insulin, and fasting glucose (FG) measured at 15-20 weeks of gestation. These underwent oral glucose tolerance test (OGTT) at 24-28 weeks.

The study results explained as follows:

  • Researchers identified 462 women, out of which 29.44 % of women developed GDM.
  • Based on HbA1c and HOMA-IR, there were four groups in the study population, with the percentages of each group being 51.30%, 15.58%, 20.56%, and 12.55%, respectively.
  • With the increase in HOMA-IR and HbA1c, GDM incidence increased with the increase of HOMA-IR and HbA1c, respectively.
  • GDM risk increased when both HOMA-IR and HbA1c were elevated.
  • In pregnant women < 35 years, there was no risk.
  • Finally, we found significantly higher FG at 24-28 weeks in the high HOMA-IR and HbA1c group among GDM-positive pregnant women.

The study has highlighted that GDM incidence increases with increasing HOMA-IR and HbA1c, respectively carrying the highest risk when maternal HOMA- IR and HbA1c are elevated in pregnant women aged ≥ 35 years.

They said, based on the results of our study, we found that among pregnant women with GDM, fasting glucose is higher at 24-28 weeks in those with elevated IR and HbA1c, independent of age.

Further reading:

Combining HbA1c and insulin resistance to assess the risk of gestational diabetes mellitus: a prospective cohort study. https://doi.org/10.1016/j.diabres.2023.110673

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Article Source : Diabetes Research and Clinical Practice

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