Laboratory monitoring of gestational diabetes

The consequences of uncontrolled gestational diabetes is severe to both maternal and fetal well-being. An ideal laboratory test to monitor gestational diabetes should accurately reflect short-term glucose changes. Glycated albumin, by virtue of its short half-life of 14 to 19 days, lends itself as a test to monitor and control gestational diabetes. Analytical approaches for the measurement of glycated albumin are reviewed, and the non-specificity of the simple colorimetric fructosamine assay is stressed. The performance characteristics of fructosamine assay, and the merits of the one hour oral glucose screening test and three-hour oral glucose tolerance test are discussed. An objective strategy for laboratory monitoring of gestational diabetes would include other assays such as fasting plasma glucose to correlate with glycated albumin (fructosamine) and even to complement the less sensitive glycated hemoglobin assay.