Jonas Ellerbrock1,2, Jolijn M H A Bohnen3, Veronica A Lopes van Balen1,2, Eva G Mulder1,2, Robert Aardenburg4, Marc E A Spaanderman1,2. 1. a Department of Obstetrics and Gynecology , Maastricht University Medical Center , Maastricht , The Netherlands. 2. c GROW School for Oncology and Developmental Biology , Maastricht University , Maastricht , The Netherlands. 3. b Department of Obstetrics and Gynecology , Maastricht University , Maastricht , The Netherlands. 4. d Department of Obstetrics and Gynecology , Zuyderland Medical Center , Heerlen , The Netherlands.
Abstract
BACKGROUND: Gestational diabetes mellitus (GDM) complicates 1-14% of pregnancies and relates to increased risk of adverse obstetric outcomes. Currently GDM is diagnosed using an oral glucose tolerance test (OGTT), which is burdensome and time intensive. OBJECTIVE: To compare current literature on whether the homeostatic model assessment beta cell function (HOMA-β) is an accurate predictor of an abnormal OGTT in pregnant women. METHODS: Pubmed, Cochrane and Embase were searched. Included studies evaluated pregnant women at risk for GDM using the homeostatic model assessment of beta cell function (HOMA-β) for the assessment of beta cell function and the OGTT. Studies with animals, non-pregnant women, women with type 2 diabetes and post-partum diabetes were excluded. The QUADAS-2 criteria were used to assess the methodological quality of studies. RESULTS: A total of 12 studies were included, reporting on 7292 women. Seven studies showed a difference in beta cell function between women with impaired glucose tolerance compared to healthy pregnant women. HOMA-β is significantly lower in impaired glucose tolerance (p < 0.001). CONCLUSIONS: Although HOMA-β is lower in women with abnormal OGTT in pregnancy, given the high degree of heterogeneity of studies, we do not propagate HOMA-β as a sole diagnostic tool replacing OGTT to diagnose GDM.
BACKGROUND:Gestational diabetes mellitus (GDM) complicates 1-14% of pregnancies and relates to increased risk of adverse obstetric outcomes. Currently GDM is diagnosed using an oral glucose tolerance test (OGTT), which is burdensome and time intensive. OBJECTIVE: To compare current literature on whether the homeostatic model assessment beta cell function (HOMA-β) is an accurate predictor of an abnormal OGTT in pregnant women. METHODS: Pubmed, Cochrane and Embase were searched. Included studies evaluated pregnant women at risk for GDM using the homeostatic model assessment of beta cell function (HOMA-β) for the assessment of beta cell function and the OGTT. Studies with animals, non-pregnant women, women with type 2 diabetes and post-partum diabetes were excluded. The QUADAS-2 criteria were used to assess the methodological quality of studies. RESULTS: A total of 12 studies were included, reporting on 7292 women. Seven studies showed a difference in beta cell function between women with impaired glucose tolerance compared to healthy pregnant women. HOMA-β is significantly lower in impaired glucose tolerance (p < 0.001). CONCLUSIONS: Although HOMA-β is lower in women with abnormal OGTT in pregnancy, given the high degree of heterogeneity of studies, we do not propagate HOMA-β as a sole diagnostic tool replacing OGTT to diagnose GDM.