Gestational diabetes mellitus-universal versus selective screening

Kaliki Hymavathi, Surekha Tadisetti, Kavya Polisetty, Malini Devi Gottipatti


Background: The prevalence of diabetes mellitus is increasing globally and Indian population is found to be ethnically in high risk group. Gestational diabetes mellitus (GDM) offers a unique and valuable opportunity for the development and implementation of clinical strategies for future prevention of diabetes. There is immense need for optimal screening strategies to spot out women with gestational diabetes.

Methods: Prospective case study.1000 pregnant women were recruited into the study at an early gestational age (<20 weeks). They were broadly divided into two groups A (without risk factors) and B (with risk factors).The whole study population (both A and B) is subjected to oral glucose challenge test (OGCT) with the concept of Universal screening. Those with abnormal OGCT are subjected to Oral glucose tolerance test (OGTT).Women with abnormal GTT values are designated as having GDM. The results are analyzed.

Results: 11.7% in group A and 25.4% in group B were found to have abnormal OGCT values and when they were subjected to OGTT 44.2% in group A and 45.8% in group B are detected to have abnormal OGTT values. 87.9% of GDM women were found to be in the age group 21-25 years in group A and in group B (59.5%) were of >26 years. labor outcome by caesarean section in GDM cases was up to 60% and 51.3% being elective sections. On the whole neonatal outcome was satisfactory.

Conclusions: As Indian population are ethnically more prone for diabetes, there is immense need to adopt universal screening for GDM in pregnancy. Thus, a timely action can be taken as depicted in the present study by screening all pregnant women, irrespective of the presence/absence of risk factors.


Gestational diabetes, Universal screening, Pregnancy outcome

Full Text:



Harrison’s Principles of Internal Medicine. 16th ed. McGraw-Hill; 2005:2152-2153.

Park’s Preventive and Social Medicine. 18th ed. Banarsidas Bhanot; 2005:312-314.

First International workshop. Conference on gestational diabetes: summary and recommendations. Diabetes Care. 1980;3:499-501.

American diabetes association: summary and recommendations of second International workshop Conference on Gestational Diabetes mellitus. Diabetes. 1985;34(2):123-6.

Metzger BE. The organising committee: summary and recommendations of third International workshop. Conference on gestational diabetes mellitus. Diabetes. 1991;40(2):197-201.

Metzger BE, Coustan DR. Summary and recommendations of the fourth international workshop conference on gestational diabetes mellitus. Diabetes Care. 1998;21:161-7.

Robert G, Moses MD, Cheung NW. Point: Universal screening for GDM. Diabetes Care. 2009;32(7);1349-51.

Dahiya K, Sahu J, Dahiya A. Maternal and fetal outcome in gestational diabetes mellitus. A study at tertiary health center in northern India. Open access library journal; 2014:1:e500.

Khurana M, Shetty M, Anand M. The clinical study of gestational diabetes mellitus. Journal of Evolution of Medical and Denta Sciences. 2015;4(29):4979-85.

Dixon DRD, Winter JTV, Nelson RL, Ogburn PL. Universal versus selective gestational diabetes screening: application of 1997. American Diabetes Association Recommendation Am J Obstet Gynecol. 1997;181:798-802.

Ramalingam K, Devisrimurari, Mounica, Bollu, Shaik, Ali F. Pregnancy outcome in gestational diabetes milletus. A prospective observational study. Indian Journal of Obstetrics and Gynecology Research. 2015;2(3):137-48.

Coustan DR, Nelson C, Carpenter MW, Carr SR, Rotondo L, Widness JA. Maternal age and screening for gestational diabetes: a population based study. Obstet Gynecol. 1989;73:557-61.

Varghese R, Thomas B, Hail MA, Rauf A, Sadi MA, Sualiti AA, et al. The prevalence, risk factors, maternal and fetal outcomes in gestational diabetes mellitus. International Journal of Drug Development And Research. 2012;4(3):356-68.

Jindal A, Ahmed F, Bhardwaj B, Chaturvedi B. Prevalence, clinical profile and outcome of gestational diabetes mellitus. J Obst Gyn of India. 2001;30(4):333.

Baliutavicience D, Petrenko V, Zalinkevicious R. Selective or universal diagnostic testing for gestational diabetes mellitus. Int J Gynaecol Obstet. 2002;78(3):207-11.

Saxena P, Tyagi S, Prakash A, Nigam A, Trivedi SS. Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of North India. J Obstet Gynaecol. 2011;6(2):8-11.