The clinical application of HbA1c in gestational diabetic diagnosis

With the alteration of dietary pattern and medical level, gestational diabetes mellitus (GDM) is brought to the forefront by OB&GY doctors. The gestational pregnant, especially those who are close to delivery are in diabetic condition, the GDM will happen if the pregnant body is failed to aggrandize insulin to overcome the insulin insufficiency in the third trimester of gestation. The gestational diabetes is abnormity in glucose tolerance in the first trimester of gestation or initial gestation identified. The occurrence rate of GDM in gestation is about 1%-13.9%, followed by serious complication. It is familiar but dangerous to both maternal and infants in obstetrics department. There is a close relationship between improper pregnancy outcome and blood sugar level, therefore, it is imperative to pay high attention to screen and diagnose GDM. What’s more, the timely diagnosis and interference during gestational period could guarantee the notable and dramatic improvement to maternal and infant prognosis. As a result, all pregnant are suggested to sift GDM according to 2nd GDM International Academic Congress keynote.

GDM test method

The most popular GDM test method is to detect venous blood sugar within one hour after meal with 50g GCT, the doubter can re-test it with 75g OGTT. But this test way is subject to several unpredicted elements: the dose of saccharides intake before examination, stress situation, nausea and vomiting after taking glucose, then, doctor must collect blood sample repeatedly, the operation is cumbersome as well, which brings patients anguish and inconvenience. In recently years, HbA1c is widely adopted to diagnose and monitor gestational diabetes in clinical application. HbA1c is regarded as a resultful test index in diabetes disease screening, diagnosis, blood sugar control and curative assessment. The formation of HbA1c is a non-enzymatic reaction with andante, successive and irreversible features, the level in blood is in direct proportion to average blood sugar in a certain period of time, but it doesn’t relate to blood sugar temporary fluctuation. Hence, the average blood sugar level in 4 weeks before blood collection could be reflected objectively, and blood sampling time, limosis or insulin intake are not considered accordingly. This is a satisfactory index to decide diabetes control in the long term.
In addition, HbA1c method is accurate, speedy, simple, low sample volume needed and insusceptible to other factors, the superiority is conspicuous.

HbA1c examination creates a new way to diabetic research, provides a creative method to monitor diabetes, which is widely utilized in some developed countries, and parts of Chinese hospitals also introduce it as a regular project to diabetes patients detection. As research continues further, the HbA1c clinical application will face capacious future.