[Postpartum diabetes screening: value of fructosamine determination]

Area of Science:

• Endocrinology
• Obstetrics
• Metabolic Disorders

Background:

• Infants born with a birthweight of 4000 g or more may indicate underlying maternal glucose metabolism issues.
• Postpartum examination of maternal glucose tolerance is recommended following delivery of a macrosomic infant.

Purpose of the Study:

• To compare the diagnostic efficacy of oral glucose tolerance testing (OGTT) versus serum fructosamine levels in identifying impaired glucose tolerance (IGT) in asymptomatic postpartum women.
• To evaluate the utility of serum fructosamine as a screening tool for gestational diabetes mellitus (GDM) in the postpartum period.

Main Methods:

• A cohort of 40 women with a history of delivering a macrosomic infant (Group I) was compared with 40 women who delivered normal birthweight infants (Group II).
• Both groups underwent a 100 g oral glucose challenge test.
• Serum fructosamine levels were measured concurrently and compared with OGTT results.

Main Results:

• Impaired glucose tolerance was detected in 15% of women in Group I versus 2.5% in Group II.
• All seven women diagnosed with IGT had serum fructosamine values within the normal range.
• Serum fructosamine determination demonstrated insufficient sensitivity for detecting IGT in asymptomatic postpartum women.

Conclusions:

• Serum fructosamine testing is not a sensitive enough method for screening asymptomatic postpartum women for impaired glucose tolerance.
• The oral glucose tolerance test remains the preferred method for screening and diagnosis of gestational diabetes mellitus in the postpartum period.