Value of early pregnancy HbA1c to predict gestational diabetes

Using strategies in early pregnancy to identify who needs an oral glucose tolerance test (OGTT) at 24–28 weeks of gestation to diagnose gestational diabetes is important to reduce the impact on women's lives and conserve health resources. Additional benefits include prompt identification and treatment of women with undiagnosed type 2 diabetes and creating opportunities to intervene in situation of high risk of pregnancy complications particularly before 14 weeks of gestation for both prevention of late gestational diabetes and treatment of early gestational diabetes. The first antenatal visit is often delayed in many regions, reinforcing the importance of tests that can be easily accomplished during the first visit. The use of HbA1c has these advantages because it does not require a fasting state and has better reproducibility than using random blood glucose. With the increasing availability of reliable point-of-care devices, results are readily available for immediate action. In this context, the study by Ponnusamy Saravanan and colleagues in The Lancet Diabetes & Endocrinology holds value.