Assessment of Fructosamine and Corrected Fructosamine as A Screening Test for Gestational Diabetes Mellitus

Abstract

ABSTRACT

Background: The prevalence of Gestational Diabetes Mellitus (GDM) is on the increase. Screening with Oral Glucose Tolerance Test (OGTT) is time consuming. Fructosamine offers an alternative in its simplicity and can be assayed anytime of the day compared to OGTT. This study aimed to evaluate serum fructosamine and corrected fructosamine usefulness in detecting GDM.

Method: This was a cross sectional study which included 160 pregnant women. recruited from the antenatal clinic of Federal Medical Centre, Makurdi. Plasma glucose, serum fructosamine and serum total protein assays were assessed. Diagnosis of GDM was made using World Health Organization (WHO) 2013 diagnostic criteria.

Results: Majority of the participants 130 (81.3%) were normoglycaemic while those with GDM were 25 (15.6%) and Diabetes in Pregnancy (DIP) were 5 (3.1%).  The mean (SD) fructosamine was higher in women with GDM [223.6 (17.6) µmol/L] compared to women without GDM [217.9 (15.0) µmol/L], however, this difference was not statistically significant, p= 0.091. Also, the mean (SD) corrected fructosamine was slightly higher in women with GDM [254.9 (19.1) µmol/L] compared to women without GDM [251.2 (22.3) µmol/L]. This difference was also not statistically significant, p= 0.435 Receiver Operator Characteristics of Fructosamine and Corrected Fructosamine to detect GDM, the Area under the curve (AUC) for fructosamine and corrected fructosamine were 0.584 and 0.594 respectively. Suggesting that they may not be good markers for detecting milder forms of hyperglycaemia.

Conclusion: Serum fructosamine and corrected fructosamine have limited use as a screening tool for GDM based on the WHO 2013 diagnostic criteria.

Key Words: Gestational Diabetes Mellitus, Hyperglycaemia in pregnancy, Diabetes in pregnancy, Fructosamine,