Serum Fructosamine and Glycosylated Hemoglobin in Monitoring the Glycemic Control in Gestational Diabetes Mellitus

Abstract

Background: Diabetes mellitus complicates 1% -2% of all pregnancies, and associates with high perinatal morbidity. Gestational diabetes mellitus (GDM) is treatable condition, and women who have adequate glycemic control during pregnancy can effectively decrease the adverse outcomes of GDM. Objectives: This study was designed to compare the serum fructosamine, and the glyco-sylated hemoglobin (HbA1c), in monitoring the glycemic control in GDM. Patients and Methods: 1516 women with GDM included, and were advised for dietary modification to achieve proper glycemic control. If the target glu-cose levels were not reached by the diet regimen or by the dietary modifica-tion, insulin was prescribed for the studied women. The average values of the pre-and post-prandial glucose levels were calculated, and the insulin doses were adjusted to achieve the target glucose values during the antenatal visits. HbA1c, and fructosamine were measured to assess the glycemic control for the studied women. Results: The fructosamine, and the HbA1c were signifi-cantly high in the uncontrolled GDM compared to controlled group, and there was positive significant correlation between fractuosamine, and HbA1c in monitoring the glycemic control in GDM (r = 0.93, and P = 0.001). The Odds ratio (OR), and relative risk (RR) analysis for the current pregnancy outcome showed that the polyhydramnios (OR 3.8; RR 3.7), the cesarean de-How to cite this paper: Farghali, M.M., Mahmoud, A.M., Baidas, G., Khalafalla, M.M., Abdelazim, I.A. and Svetlana, S. (2018) Serum Fructosamine and Glycosy-lated Hemoglobin in Monitoring the Gly-cemic Control in Gestational Diabetes Mel-litus. Open Journal of Obstetrics and Gy-necology, 8, 630-645. DOI: 10.4236/ojog.2018.86068 631 Open Journal of Obstetrics and Gynecology livery (OR 1.7; RR 1.4), the fetal macrosomia (OR 6.4; RR 6.3), the fetal ano-malies (OR 6.5; RR 6.4), and the (IUFD) intrauterine fetal death (OR 8.7; RR 8.6) were significantly high in uncontrolled GDM group. In addition, the (NND) neonatal death (OR 11.6; RR 11.4), the neonatal intensive care unit (NICU) admission (OR 3.1; RR 2.9), the neonatal hyperbilirubinemia (OR 3.7; RR 3.6), the transient tachypnea of the newborn (OR 3.1; RR 2.9), and the neonatal hypoglycemia (OR 3.5; RR 3.4) were significantly high in uncon-trolled GDM group. Conclusion: Fructosamine assay is simple, reliable, use-ful indicator for the glycemic control in GDM over the last 2 -3 weeks, and poor glycemic control in GDM increases the risk of adverse maternal and neonatal outcomes.