Gestational diabetes & diabetes in pregnancy
A1c versus oral glucose tolerance test for chronic glycemic surveillance in women with previous gestational diabetes
Authors' conclusion
In women with previous GDM, dysglycemia on OGTT identifies a higher risk metabolic phenotype than when diagnosed by A1c, suggestive of more informative and robust glycemic surveillance by OGTT.
Study context
- Population
- Women with previous GDM, assessed at 3 and 5 years postpartum
- Participants
- 111 women
- Exposure
- A1c vs fasting glucose vs oral glucose tolerance test (OGTT) for glycaemic surveillance after GDM
- Outcome
- Dysglycemia (pre-diabetes/diabetes) by diagnostic method
- Follow-up
- 3-years postpartum
Main finding
As reported in the abstract
Fasting glucose alone
no women
A1c alone
10
events
OGTT alone
24
events
A1c and OGTT
16
events
- Beta-cell function progressively worsened from A1c alone to OGTT alone to both criteria (ISSI-2)
- P < 0.001
- Beta-cell function progressively worsened from A1c alone to OGTT alone to both criteria (IGI/HOMA-IR)
- P = 0.01
Observational data: associations, not effects.
Further findings
Events
| Outcome | A1c alone | OGTT alone | Both |
|---|---|---|---|
| Dysglycemia by diagnostic test · 5 years postpartum | 13 | 27 | 21 |
- Dysglycemia by diagnostic test — Beta-cell function progressively decreased from A1c alone to OGTT alone to both: ISSI-2
- p < 0.001
- Dysglycemia by diagnostic test — Beta-cell function progressively decreased: IGI/HOMA-IR
- p < 0.001
- Dysglycemia by diagnostic test — Worsening insulin sensitivity/resistance across groups: Matsuda index
- p < 0.001
- Dysglycemia by diagnostic test — Worsening insulin sensitivity/resistance across groups: HOMA-IR
- p = 0.002
- Dysglycemia by diagnostic test — Rising fasting glucose across groups
- p = 0.008
Original publication
A1c versus oral glucose tolerance test for chronic glycemic surveillance in women with previous gestational diabetes. Diabetes Obes Metab. Published 5 June 2025. doi:10.
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