1, 5-Anhydroglucitol and Neonatal Complications in Pregnancy Complicated by Diabetes.

Publication Type:

Journal Article

Source:

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, p.1-24 (2015)

Abstract:

OBJETIVE To determine the association of 1, 5-Anhydroglucitol (1, 5-AG) with neonatal birth weight (NBW) and neonatal hypoglycemia (+NH) in pregnancies complicated by diabetes. METHODS Retrospective cohort of 102 women, 17 with gestational diabetes (GDM), 48 with type 1 (T1DM) and 37 with type 2 diabetes (T2DM). 1, 5-AG and hemoglobin A1C (A1C) values throughout pregnancy were extracted. Linear regression was used to assess their association with NBWs z-scores adjusting for maternal age, ethnicity and BMI. +NH was defined by a note in the infant record, glucose <1.7 mmol/L in the first 24 h or <2.5 mmol/L in the first 48 h after birth. A t-test or Welch's approximate t-test was used to compare the mean 1, 5-AG and A1C of mothers with +NH vs. those without (-NH), adjusted for gestational age and analyzed by diabetes type and across trimesters. RESULTS Mean 1, 5-AG differed across groups: T1DM 3.77±2.82 μg/ml, T2DM 5.73±4.38 μg/ml, GDM 8.89±4.39 μg/ml; p<0.0001, suggesting less glucose exposure in GDM relative to T1DM or T2DM. A negative linear association was found between mean 1, 5-AG and z-scores: R=-.28, p=0.005. In contrast, the association between mean A1C and z-scores was weaker: R=0.15, p=0.14. The mean 1, 5-AG tended to be lower in the +NH cohort vs. -NH, p=0.08; and among women with GDM, statistically significant, p=0.01. CONCLUSION The association of 1, 5-AG with complications related to glycemic exposure supports the notion of its utility as an adjunct glycemic biomarker in pregnancies complicated by diabetes and across trimesters.