Serum fructosamine for diagnosis of gestational diabetes: a perspective

Recently, several studies proposed continuous glucose monitoring (CGM) as a reliable diagnostic test for Gestational Diabetes Mellitus (GDM). These studies have challenged the validity of Oral Glucose Tolerance Tests (OGTT) recommended by American college of Obstetricians and Gynecologists (ACOG) and American Diabetes Association (ADA) because of a lack of preparation for 3-hour OGTT with least daily intake of 150gm of carbohydrates for 3 days before testing. Moreover, OGTT results vary widely due to artificial milieu as well as changing daily carbohydrate intake, both quantity and the type, during the previous few days. Recently, we have documented subnormal and significantly lower Fructosamine concentrations in pregnant women without GDM when compared to those with GDM. Finally, we recently observed that Fructosamine compares more favorably with CGM for 2 weeks in pregnant women with abnormal 3-hour OGTT, suggestive of false positivity. Therefore, Fructosamine may be as accurate as CGM and more accurate than both Glucose Tolerance Tests.