Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 25, 2015; 6(8): 1045-1056
Published online Jul 25, 2015. doi: 10.4239/wjd.v6.i8.1045
Indicators of glycemic control in patients with gestational diabetes mellitus and pregnant women with diabetes mellitus
Kunihiko Hashimoto, Masafumi Koga
Kunihiko Hashimoto, Department of Internal Medicine, NTT West Osaka Hospital, Osaka 543-8922, Japan
Masafumi Koga, Department of Internal Medicine, Kawanishi City Hospital, Kawanishi, Hyogo 654-8533, Japan
Author contributions: Hashimoto K wrote the first draft of the manuscript; Koga M edited and supervised the writing of the manuscript.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Masafumi Koga, MD, PhD, Department of Internal Medicine, Kawanishi City Hospital, Kawanishi, Hyogo 664-8533, Japan. m-koga@kawanishi-city-hospital.com
Telephone: +81-72-7942321 Fax: +81-72-7946321
Received: November 26, 2014
Peer-review started: November 29, 2014
First decision: January 20, 2015
Revised: February 20, 2015
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: July 25, 2015
Abstract

Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternal-infant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus (GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c (HbA1c); however, we have demonstrated that HbA1c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, large-population epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.

Keywords: Glycemic control, Hemoglobin A1c, Glycated albumin, 1,5-anhydroglucitol, Fructosamine, Gestational diabetes, Diabetes mellitus, Pregnancy

Core tip: In patients with gestational diabetes mellitus (GDM) and pregnant women with diabetes, stricter glycemic control is required to reduce the incidence of perinatal maternal-infant complications. We have demonstrated that hemoglobin A1c does not reflect glycemic control accurately during pregnancy because of iron deficiency. On the other hand, glycated albumin is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes. However, large-population epidemiological studies are necessary. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.