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Vol. 71, No. 3, 2011
Issue release date: April 2011
Section title: Original Article
Gynecol Obstet Invest 2011;71:207–212
(DOI:10.1159/000318705)

Gestational Diabetes: An Evaluation of Serum Fructosamine as a Screening Test in a High-Risk Population

Agarwal M.M. · Dhatt G.S. · Othman Y. · Ljubisavljevic M.R.
Departments of aPathology and bPhysiology, Faculty of Medicine, UAE University, and cDepartment of Pathology, Tawam Hospital, Al Ain, United Arab Emirates

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Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: 2/10/2010
Accepted: 5/7/2010
Published online: 12/15/2010

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 3

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: http://www.karger.com/GOI

Abstract

Aim: To evaluate the value of serum fructosamine as a screening test for gestational diabetes mellitus (GDM). Methods: 849 pregnant women underwent the one-step 75 g oral glucose tolerance test (OGTT) for universal screening of GDM. The fasting serum fructosamine (cFruc) was assessed using the area under the receiver operating characteristic curve (AUC). The GDM diagnostic criteria used were those of the American Diabetes Association; however, the cFruc performance was also evaluated using criteria of the World Health Organization, Australian (ADIPS), European (EASD) and International Association of Diabetes and Pregnancy Study Groups (IADPSG). Results: 113 (13.3%) women had GDM. The AUC of the cFruc was 0.60 (95% CI 0.54–0.66). A cFruc threshold of 237 µmol/l achieved an acceptable sensitivity of 85.8% (95% CI 78.0–91.0%), but the associated specificity remained poor at 23.4% (95% CI 20.0–27.0%) with a positive predictive value of just 14.7%. Overall, over 4 out of 5 pregnant women, being over this cutoff, would need the confirmatory OGTT. No cFruc threshold reached acceptable likelihood ratios to rule-in or rule-out GDM. The AUC for cFruc remained unacceptable independent of the diagnostic criteria. Conclusions: Despite all the advances in technology, serum fructosamine is a poor test to screen for GDM.


Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: 2/10/2010
Accepted: 5/7/2010
Published online: 12/15/2010

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 3

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: http://www.karger.com/GOI


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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