AN EVALUATION OF FRUCTOSAMINE ESTIMATION IN SCREENING FOR GESTATIONALDIABETES-MELLITUS

Although persuasive arguments against routine screening for gestationa l diabetes mellitus (CDM) have been made, it is widely but not univers ally performed as a part of antenatal care. There is no international agreement on methods or criteria used for screening (or for diagnosis) , and administered glucose-load methods have significant practical dif ficulties in a busy antenatal clinic setting. However, recent evidence supports the concept of an increased level of importance being given to a diagnosis of CDM, with interest in the fetal and neonatal origins of adult disease being added to the short-term obstetric and fetal co ncern during pregnancy. A second generation fructosamine test, correct ed for total protein, has been evaluated as a practical alternative to glucose screening for GDM in a busy, multi-ethnic antenatal clinic. T his achieved a 79.4 % sensitivity and a 77.3 % specificity for a diagn osis of CDM confirmed by a glucose tolerance test using Carpenter's mo dified criteria. In view of the organizational simplicity of this samp le/test requirement, a wider evaluation is suggested together with a r e-evaluation of clinical outcome criteria rather than blood glucose le vels alone.