1,5-ANHYDROGLUCITOL AND NEONATAL COMPLICATIONS IN PREGNANCY COMPLICATED BY DIABETES

Area of Science:

• Endocrinology
• Maternal-Fetal Medicine
• Clinical Chemistry

Background:

• Diabetes in pregnancy, including gestational diabetes (GDM), type 1 diabetes mellitus (T1DM), and type 2 diabetes mellitus (T2DM), poses risks for neonatal complications.
• Accurate glycemic monitoring is crucial for optimizing maternal and neonatal outcomes.

Purpose of the Study:

• To investigate the association of 1,5-anhydroglucitol (1,5-AG) with neonatal birth weight (NBW) and neonatal hypoglycemia (+NH) in pregnancies complicated by diabetes.
• To compare the utility of 1,5-AG with glycated hemoglobin A1C (A1C) as a glycemic biomarker.

Main Methods:

• Retrospective cohort study of 102 pregnant individuals with diabetes (GDM, T1DM, T2DM).
• Collected 1,5-AG and A1C values throughout pregnancy.
• Assessed associations with NBW z-scores using linear regression and with +NH using t-tests, adjusting for relevant covariates.

Main Results:

• Mean 1,5-AG levels varied significantly across diabetes types, indicating differential glucose exposure.
• A significant negative association was observed between mean 1,5-AG and NBW z-scores (R = -0.28, P = .005), while A1C association was weaker (R = 0.15, P = .14).
• Mean 1,5-AG tended to be lower in neonates with hypoglycemia, particularly significant in the GDM subgroup (P = .01).

Conclusions:

• 1,5-AG demonstrates a stronger association with NBW z-scores compared to A1C in diabetic pregnancies.
• 1,5-AG shows potential as an adjunct biomarker for assessing glycemic exposure and predicting neonatal complications.
• Findings support the utility of 1,5-AG across trimesters for monitoring pregnancies complicated by diabetes.