DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183311

Comparison of DIPSI guidelines versus conventional OGTT for diagnosis of gestational diabetes mellitus

Grishma Girish Desai, Pundalik Sonawane

Abstract


Background: Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance with recognition or onset during pregnancy is associated with a higher rate of maternal and fetal compromise. OGTT is the current gold standard for screening for GDM. It is a two-step test which requires the pregnant woman to be in a fasting state for a long duration. DIPSI is a one-step procedure for diagnosing GDM does not require patients in a fasting state and is a simple, economical and feasible alternate in Indian scenario. The aim of this study is to compare DIPSI criteria-based test with conventional OGTT for diagnosis of GDM.

Methods: A hospital-based screening study was conducted at Department of Obstetrics and Gynecology, K J Somaiya Medical College and hospital, Mumbai for duration of May 2015 to June 2016. A total of 200 consecutive pregnant women in the second and third trimester of pregnancy registered at our antenatal clinic and satisfying the eligibility criteria were taken in the study after informed consent. Pregnant women with 2-h PG ≥ 7.8 mmol/L (DIPSI criterion) were diagnosed as GDM and rest were classified as normal glucose tolerant (NGT) women. One week later all of them were made to undergo the conventional 75 gm OGTT. Data was analyzed using statistical software SPSS ver. 21.

Results: The sensitivity and specificity of DIPSI was 86.8% and 98.8% with PPV and NPV of 94.3% and 97.0% and overall diagnostic accuracy was 96.5%.

Conclusions: The results of present study show that DIPSI is a simple, single, convenient, economical screening test for GDM and can be used as both diagnostic as well as screening test with good diagnostic efficacy.


Keywords


Diabetes, Diagnosis, DIPSI, GDM, OGTT, Pregnancy

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References


Yogev Y, Chen R, Langer O, Hod M. Diurnal Glycemic profile characterization in non-diabetic non-obese subjects during the first trimester. The 37th Annual Meeting of the Diabetes and Pregnancy Study Group, Myconos-Hellas: September 2005.

American Diabetes Association; Gestational diabetes mellitus (Position statement). Diabetes Care. 2004;27(Suppl 1):S88-90.

Kjos SL, Buchanan TA. Gestational diabetes mellitus. New Eng J Med. 1999;341(23):1749-56.

Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS, et al. Effect of treatment of gestational diabetes mellitus. N Engl J Med. 2005; 352:2477-86.

Gayle C, Germain S, Marsh MS, Rajasingham D, Brackenridge A, Carroll P, et al. Comparing pregnancy outcomes for intensive versus routine antenatal treatment of GDM based on a 75 gm OGTT 2- h blood glucose (>140 mg/dl). Diabetologia. 2010;53:S435.

Wahi P, Dogra V, Jandial K, Bhagat R, Gupta R, Gupta S, et al. Prevalence of Gestational Diabetes Mellitus (GDM) and its outcomes in Jammu region. J Assoc Physicians India. 2011;59:227-30.

Cosson E. Screening and insulin sensitivity in gestational diabetes. Abstract volume of the 40th Annual Meeting of the EASD, September 2004: A 350.

V Seshiah. DIPSI Guidelines - Kolkata declaration, fifth national conference of diabetes in pregnancy study group, India. The J Assoc Phys India. 2010;58:329-30.

JimennezMoLeon J, Bueno-Cavanillas A, Luna-Del-Castillo J D, Lardelli-Claret P, García-Martin M, Gálvez-Vargas R. Predictive value of screen for GDM, Influence of associated risk factors. Acta Obstet Gynaecol. 2000;79:991-8.

Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Arthi T, Thamizharasi M, Datta M. Prevalence of gestational diabetes mellitus in South India (Tamil Nadu): a community-based study. JAPI. 2008 May;56:329-3.

Sridhar GR, Nagmani G. Gestational diabetes and other endocrine disorders during pregnancy. J Obstet Gynaecol India. 2003;35:140.

Balaji V, Balaji M, Anjalakshi C, Cynthia A, Arthi T, Seshiah V. Diagnosis of gestational diabetes mellitus in Asian-Indian women. Indian J Endocrinol Metabol. 2011 Jul 1;15(3):187.

Seshiah V, Balaji V, Balaji MS, Sanjeevi CB, Green A. Gestational diabetes mellitus in India. J Assoc Phys India. 2004;52:707-11.

Sharma A, Gupta M, Agrawal A. Comparison of diagnostic accuracy of two one step procedures for screening of gestational diabetes mellitus. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):81-5.

Polur PK, Bandela PV, Hindumathi SS. Diabetes in pregnancy study group in India (DIPSI): a novel criterion to diagnose. GDM. 2016;10:1-6.