A study examining the association of haemoglobin A1c (HbA1c) to insulin sensitivity and beta-cell function in early pregnancy revealed that HbA1c measurements might be a useful screening tool for earlier identification of women at risk for more severe hyperglycaemia in pregnancy, according to an article published in the BMJ Open Diabetes Research & Care.
The analysis included 220 pregnant women, who had an HbA1c measurement as well as an oral glucose tolerance test (OGTT) with multiple measurements of glucose, insulin, and C-peptide for evaluation of insulin sensitivity and beta-cell function at 16th gestational week, and followed until the end of pregnancy.
The results show that elevated HbA1c (≥5.7%) was associated with altered glucose dynamics during the OGTT performed at first or early second trimester. Women with increased HbA1c showed impaired beta-cell function and differences in disposition index independent of body mass index (BMI) status. Further, elevated HbA1c was associated with a higher risk for delivering large-for-gestational-age infants, even after adjustment for gestational diabetes mellitus (GDM) status.
These associations on pathophysiological level advocate for the utility of HbA1c as an early predictor for pregnancies at glucometabolic risk that warrant further research, the authors conclude.