1.5-anhydrogluci̇tol i̇n gestati̇onal di̇abetes

Gestational Diabetes Mellitus (GDM) is the most common cause of hyperglycemia encountered during pregnancy. The aim of this study is to evaluate the importance of long and short term markers of glycemic status; HbA1c, glycated albumin and 1,5-Anhydroglucitol (1,5-AG) in GDM. The study was planned as a controlled cross-sectional study and carried out between February and June 2014. The study group was composed of 80 pregnant women, 40 with GDM and 40 with normal glucose tolerance. Their medical history were taken and drug use was also questionned. GDM was diagnosed according to ADA 2013 criteria. Glycemic markers were measured in the oral glucose tolerance test (OGTT) blood samples of women in their 24-28th weeks of gestation, other biochemical parameters which could affect their levels were also measured. 1,5-AG levels for all three OGTT samples were strongly correlated. HbA1c was significantly higher in GDM group when compared with the controls, whereas 1,5-AG levels were significantly lower. There wasn't any statistically significant difference between the two groups for glycated albumin. While HbA1c levels were correlated with fasting blood glucose, first hour glucose and MCV, 1,5-AG was only correlated with the first hour glucose. In the lineer regression analysis, MCV was the powerful determinant of HbA1c levels and the first hour glucose of the OGTT was the only determinant of 1,5-AG levels. No difference was found for the diagnostic performances of 1,5-AG and HbA1c (AUC values were 0.722 and 0.756 respectively). With the combined use of 1,5-AG and fasting blood glucose, sensitivity and specificity were determined as 90% and 66%. It was found that the use of each of these parameters alone didn't have adequate sensitivity and specificity in diagnosing GDM. Although HbA1c and 1,5-AG had similar powers in GDM diagnosis, iron deficiency state limits the use of HbA1c in pregnancy. The combined use of 1,5-AG with fasting glucose can be helpful in identifying the low risk group for development of GDM.