Show simple item record

dc.contributor.authorO'Dea, Angela
dc.date.accessioned2014-10-21T09:34:33Z
dc.date.available2014-10-21T09:34:33Z
dc.date.issued2013
dc.identifier.citationNoctor, E,Crowe, C,Carmody, LA,Avalos, GM,Kirwan, B,Infanti, JJ,O'Dea, A,Gillespie, P,Newell, J,McGuire, B,O'Neill, C,O'Shea, PM,Dunne, FP (2013) 'ATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetes'. European Journal Of Endocrinology, 169 :681-687.en_US
dc.identifier.urihttp://hdl.handle.net/10379/4652
dc.descriptionArticleen_US
dc.description.abstractObjective: Previous gestational diabetes (GDM) is associated with a significant lifetime risk of type 2 diabetes. In this study, we assessed the performance of HbA1c and fasting plasma glucose (FPG) measurements against that of 75 g oral glucose tolerance testing (OGTT) for the follow- up screening of women with previous GDM.Methods: Two hundred and sixty-six women with previous GDM underwent the follow- up testing (mean of 2.6 years (S.D. 1.0) post- index pregnancy) using HbA1c (100%), and 75 g OGTT (89%) or FPG (11%). American Diabetes Association (ADA) criteria for abnormal glucose tolerance were used.Design, cohort study, and results: The ADA HbA1c high-risk cut-off of 39 mmol/mol yielded sensitivity of 45% (95% CI 32, 59), specificity of 84% (95% CI 78, 88), negative predictive value (NPV) of 87% (95% CI 82, 91) and positive predictive value ( PPV) of 39% (95% CI 27, 52) for detecting abnormal glucose tolerance. ADA high-risk criterion for FPG of 5.6 mmol/ l showed sensitivity of 80% ( 95% CI 66, 89), specificity of 100% (95% CI 98, 100), NPVof 96% (95% CI 92, 98) and PPVof 100% (95% CI 91, 100). Combining HbA1c >= 39 mmol/ mol with FPG >= 5.6 mmol/ l yielded sensitivity of90%(95% CI 78, 96), specificity of 84% (95% CI 78, 88), NPV of 97% (95% CI 94, 99) and PPVof 56% (95% CI 45, 66).Conclusions: Combining test cut- offs of 5.6 mmol/l and HbA1c 39 mmol/mol identifies 90% of women with abnormal glucose tolerance post- GDM ( mean 2.6 years (S. D. 1.0) post- index pregnancy). Applying this follow-up strategy will reduce the number of OGTT tests required by 70%, will be more convenient forwomen and their practitioners, and is likely to lead to increased uptake of long-term retesting by these women whose risk for type 2 diabetes is substantially increased.en_US
dc.formatapplication/pdfen_US
dc.language.isoenen_US
dc.publisherEuropean Society of Endocrinologyen_US
dc.relation.ispartofEuropean Journal Of Endocrinologyen
dc.subjectImpaired glucose-toleranceen_US
dc.subjectMissed opportunitiesen_US
dc.subjectDiagnostic criteriaen_US
dc.subjectHemoglobin a(1c)en_US
dc.subjectLifestyleen_US
dc.subjectMellitusen_US
dc.subjectPreventionen_US
dc.subjectPregnancyen_US
dc.subjectHistoryen_US
dc.subjectRisken_US
dc.titleATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetesen_US
dc.typeArticleen_US
dc.date.updated2014-10-20T09:43:41Z
dc.identifier.doiDOI 10.1530/EJE-13-0491
dc.local.publishedsourcehttp://dx.doi.org/10.1530/EJE-13-0491en_US
dc.description.peer-reviewedpeer-reviewed
dc.contributor.funder|~|
dc.internal.rssid5623689
dc.local.contactAngela O'Dea, School Of Medicine, 1 Distillery Road, Nui Galway. 3608 Email: angela.odea@nuigalway.ie
dc.local.copyrightcheckedYes
dc.local.versionACCEPTED
nui.item.downloads362


Files in this item

Attribution-NonCommercial-NoDerivs 3.0 Ireland
This item is available under the Attribution-NonCommercial-NoDerivs 3.0 Ireland. No item may be reproduced for commercial purposes. Please refer to the publisher's URL where this is made available, or to notes contained in the item itself. Other terms may apply.

The following license files are associated with this item:

Thumbnail

This item appears in the following Collection(s)

Show simple item record