DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180869

Comparative study of DIPSI and IADPSG criteria for diagnosis of GDM

Swathy Srinivasan, Rani P. Reddi

Abstract


GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The prevalence of GDM varies, widely based on the diagnostic criteria used and the ethnic group studied. It is associated with adverse maternal and perinatal outcome. Incidence of GDM in India is 1-14%. There are several screening and diagnostic tests for GDM. It is important to diagnose early and treat to prevent these complications. The present study was done to compare Diabetes in Pregnancy Study Group India (DIPSI) with International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for diagnosis of GDM and to assess the validity of these methods.

Methods: It was a cross sectional study done in 144 pregnant women who fulfilled the inclusion criteria. They underwent non - fasting OGTT with 75 grams glucose which was given irrespective of the last meal. A venous blood sample was drawn two hours after glucose administration. They were advised to come two to three days later and repeated with 75 grams OGTT after an overnight fast of atleast 8 hours. Venous blood sample was drawn at fasting, one hour and two hours after load with 75 grams of glucose. Plasma glucose was measured by using an autoanalyzer by glucose - oxidase peroxidase (GOD - POD) technique.

Results: The epidemiological parameters like Age, BMI, Parity and Gestational age did not have any difference between two groups. 17.4% was diagnosed by DIPSI criteria and 15.3% was diagnosed by IADPSG criteria and 6.9% was diagnosed by both. Sensitivity and specificity of DIPSI was 45% and87% and sensitivity and specificity of IADPSG was 40% and89% respectively. According to kappa statistics, the p-value is 0.000.

Conclusions: In present study it was concluded that screening is very essential in all pregnant women due to high prevalence of GDM in India. By comparing these two criteria, sensitivity of DIPSI was found better than IADPSG criteria in diagnosing GDM. Though IADPSG is universally accepted for diagnosis, DIPSI has still got a place in low resource countries as it is easy, cost effective and non fasting test.


Keywords


DIPSI, GDM, IADPSG

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References


Metzger BE. Organizing committee: Summary and recommendations of the third international workshop conference on gestational diabetes mellitus. Diabetes. 1991;40 S2:197-201.

International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation, 2013. Available at http:11 www.idf.org/sites/ default/files/ EW-6E-Atlas-Full-0.Pdf. Accessed on 25 July 2014.

Madsen JK, Haunsoe S, Helquit S, Hommel E, Malthe I, Pedersen NT, et al. Prevalence of hyperglycemia and undiagnosed diabetes mellitus in patients with acute myocardial infarction. Acta Med Scand. 1986;220:329-32.

Zargar AH, Sheikh MI, Bashir MI, Massodi SR, Laway BA, Wani AI, et al. Prevalence of gestational diabetes mellitus in kashmiri women from the Indian subcontinent. Diabetes Res Clin Pract. 2004;66:139-45.

Mohan V, Mahalakshmi MM, Bhavadharini B, Maheshwari K, Kaliyarasi G, Anjana RM, et al. Comparison of screening for gestational diabetes mellitus by oral glucose tolerance tests done in the non - fasting (random) and fasting states. Acta Diabetol. 2014;51:1007-13.

Goldberg RJ, Hanley AJG, Yec, Ziman B, Sermer M, Retnakaran R et al. Circadian variation in the response to the glucose challenge test in pregnancy. Diabetes Care. 2012;35:1578-84.

Geetha N, Sangeetha KG. Comparison of IADPSG and DIPSI criteria for diagnosis of gestational diabetes mellitus. IOSR JDMS. 2016;15(9):1-4.

Vij P, Jha S, Gupta SK, Aneja A, Mathur R, Waghdhare S, et al. Comparison of DIPSI and IADPSG criteria for diagnosis of GDM: A study in a north Indian tertiary center. Int J Diabetes Dev Ctries. 2015;35(3):285-8.

Polur H, Rrora R, Vinodh Bandela P. A mini review on diagnostic criteria of gestational diabetes mellitus. J Pharm Sci Res. 2015;7(8):538-41.

Bhavadharini B, Uma R, Saravanan P, Mohan V. Screening and diagnosis of gestational diabetes mellitus-relevance to low and middle income countries. Clini Diabetes Endocrinol. 2016;2(13):1-8.