Abstract :
Background: Gestational diabetes mellitus (GDM) is a common pregnancy complication linked to various maternal and neonatal risks. Early diagnosis is crucial for timely intervention and reducing complications. This study evaluates the efficacy of HbA1c as an early diagnostic adjunct for GDM, combined with fasting blood sugar (FBS) levels, to establish a cost-effective first-trimester screening method.Materials and Methods: A prospective observational study was conducted from 2023 to 2025 at Shri B. M. Patil Medical College, Karnataka, India, involving 123 antenatal women. Inclusion criteria encompassed women aged ?18 years, in their first trimester, with confirmed intrauterine pregnancy, and no prior diabetes or GDM history. HbA1c and FBS were measured in the first trimester. Those with abnormal FBS or HbA1c were further tested using the DIPSI method and oral glucose tolerance test (OGTT) for GDM diagnosis. The HbA1c threshold of 6.5% was used in line with ADA standards for overt diabetes. Maternal and neonatal outcomes were assessed, and data analyzed using SPSS software.Results: A total of 16 women were diagnosed with GDM (13%). The mean HbA1c in the first trimester was significantly higher in the GDM group (5.64 ± 0.32) compared to the non-GDM group (4.99 ± 0.46). HbA1c showed high sensitivity (97.1%) and specificity (100%) for diagnosing GDM. Abnormal FBS was noted in 75% of the GDM group compared to 9.3% in the non-GDM group. Neonatal outcomes, including higher birth weight and NICU admissions, were significantly worse in the GDM group.Conclusion: HbA1c, when used alongside FBS, may serve as an effective early predictor for GDM but cannot substitute the standard DIPSI or OGTT diagnostic criteria. Early identification through combined screening enables timely intervention and may help reduce maternal and neonatal risks.
Keyword :
Gestational diabetes mellitus, Early diagnosis, HbA1c.