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Inverse association between 1,5-anhydroglucitol and neonatal diabetic complications

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Abstract

Purpose

A glycemic control marker to predict neonatal diabetic complications is unavailable. We aimed to examine if 1,5-anhydroglucitol (1,5-AG) can predict neonatal complications in women with diabetes in pregnancy.

Methods

Prospective observational study from December 2011 to August 2013. We recruited 105 women, 70 diabetic (gestational and pregestational) and 35 nondiabetic. 1,5-AG at birth was compared between the two groups.

In the diabetic group 1,5-AG, HbA1c, and fructosamine were measured before glycemic control initiation (first visit), after 4–6 weeks (second visit), and at delivery. Women were divided to poor (1,5-AG values below median at birth) and good (1,5-AG values at median and above) glycemic control groups. Mean daily glucose charts were collected. The primary outcome was a composite of neonatal diabetic complications: respiratory distress, hypoglycemia, polycythemia, hyperbilirubinemia, and large for gestational age.

Results

Mean 1,5-AG in the nondiabetic group was similar to that of the diabetic group without the composite outcome and was significantly higher than in the diabetic group with the composite outcome.

The rate of the composite outcome was higher in the poor glycemic control group compared with the good glycemic control group (adjusted odds ratio (OR) 3.8 95% CI [1.2–12.3]). Only 1,5-AG was inversely associated with the composite outcome at all time points; the second visit was the only independent risk factor in multivariable logistic regression (OR 0.7 95% CI 0.54–0.91). The rest of the glycemic markers were not associated with neonatal composite outcome.

Conclusions

1,5-AG is inversely associated with neonatal diabetic complications and is superior to other glycemic markers in predicting those complications.

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Funding

This work was supported by the Legacy Heritage Fund.

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Author notes

  1. These authors contributed equally: Enav Yefet, Shams Twafra

Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Emek Medical Center, Afula, Israel

    Enav Yefet, Noura Hissin & Zohar Nachum

  2. Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Mount Carmel, Haifa, Israel

    Shams Twafra & Neetsa Mirsky

  3. Clinical Chemistry Laboratory, Emek Medical Center, Afula, Israel

    Shams Twafra & Neta Shwartz

  4. Neonatology Department, Emek Medical Center, Afula, Israel

    Jamal Hasanein

  5. Rappaport Faculty of Medicine, Technion, Haifa, Israel

    Raul Colodner & Zohar Nachum

  6. Molecular Microbiology Laboratory, Emek Medical Center, Afula, Israel

    Raul Colodner

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  1. Enav Yefet
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  2. Shams Twafra
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Correspondence to Enav Yefet.

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Yefet, E., Twafra, S., Shwartz, N. et al. Inverse association between 1,5-anhydroglucitol and neonatal diabetic complications. Endocrine 66, 210–219 (2019). https://doi.org/10.1007/s12020-019-02058-w

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  • DOI: https://doi.org/10.1007/s12020-019-02058-w

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