The feasibility study of glycosylated hemoglobin combined with 2 point blood sugar test in the diagnosing of gestational diabetes mellitus

Objective: To analyze the feasibility of hemoglobin A1c(HbA1c) combined with 2 point blood sugar test in the diagnosing of gestational diabetes mellitus(GDM).Methods: The pregnant women with 24 to 28 weeks from the Affiliated Hospital of Guangdong Medical College and Dongguan Houjie Hospital were screened by GDM from Jun 2012 to Feb 2013.The pregnant women with suspected GDM were detected using glucose tolerance test(OGTT) and HbA1c combined with 2 point blood sugar test,respectively.The screening results and clinical significance of two methods were evaluated.Results: Compared with the gold standard,the sensitivity and coincidence rate of 2 points method within 1 to 2 h were higher when OGTT collected blood 2 times(P<0.01).The average levels of HbA1c in 84 patients with suspected GDM(8.73±0.59)% were significantly higher than the normal value(6%)(P<0.01).The differences of HbA1c combined with 2 point blood sugar test test and a single test in the diagnosis of GDM had no statistically significant(P>0.05).The diagnostic sensitivity and specificity of HbA1c combined with 2 point blood sugar test were 87.5% and 84.9%,respectively,and its area under the curve was 0.926(P<0.05).The economic and social benefits of HbA1c combined with 2 point blood sugar test were significantly higher than those of 75 g OGTT test(P<0.01).Conclusions: HbA1c combined with 2 point method can largely reduce the pregnant women pain caused by collecting blood for 4 times,missed diagnosis rate of 2 points method and incidence of pregnancy complications,which can make the GDM patients get the attention and treatment in time.