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Homeostatic model assessment of beta cell function predicting abnormal oral glucose tolerance testing in pregnancy: a systematic review and meta-analysis. | LitMetric

AI Article Synopsis

  • Gestational diabetes mellitus (GDM) affects a notable percentage of pregnancies and can lead to serious complications, with current diagnosis relying on a cumbersome oral glucose tolerance test (OGTT).
  • The study aimed to evaluate whether the homeostatic model assessment of beta cell function (HOMA-β) could serve as a reliable predictor for abnormal OGTT results in pregnant women at risk for GDM.
  • Analysis of 12 studies involving 7,292 women found that HOMA-β levels were significantly lower in those with abnormal glucose tolerance, but due to variability in the studies, HOMA-β should not replace OGTT as the primary diagnostic method for GDM.

Article 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.

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Source
http://dx.doi.org/10.1080/09513590.2017.1369516DOI Listing

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