Screening for gestational diabetes mellitus by two step method and the pregnancy outcome: a study in Indian women


  • Suguna Srinivasan Department of Obstetrics and Gynaecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai Kancheepuram, Tamilnadu, India
  • Vijayalakshmi Palanisamy Department of Obstetrics and Gynaecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai Kancheepuram, Tamilnadu, India



Gestational diabetes mellitus, Glucose challenge test, Lower segment cesarean section, Oral glucose tolerance test


Background: In recent times, gestational diabetes is becoming more common Worldwide and complications are seen in fetal development, growth, labour and delivery due to maternal hyperglycemia. Gestational Diabetes Mellitus(GDM) is associated with adverse maternal and fetal outcomes. Among South Asian Population, Indian Women are at high risk of developing carbohydrate intolerance during pregnancy. Hence this study is undertaken to screen for gestational diabetes mellitus by two step method in Indian Women.

Methods: This study was done in 153 nondiabetic pregnant women of gestational age 24-28 weeks, excluding diabetes mellitus diagnosed prior to pregnancy. Two step method was followed in the present study and GDM was diagnosed and the pregnancy outcomes were noted.

Results: In our study the prevalence of GDM is 8.1% by two step method. Most of the women diagnosed with GDM were of age 26-30 yrs (41.66%). Among the women who were diagnosed as GDM, (58.33%) cases required Insulin along with diet control. In our study 33.33% had vaginal delivery, 8.33% had Emergency LSCS and 58.33% had Elective LSCS.

Conclusion: Indian Women have high prevalence of GDM, hence universal screening is essential to diagnose GDM, which will improve the pregnancy outcome.


Lee AJ, Hiscock RJ, Wein P, Walker SP, Permezel M. Gestational diabetes Mellitus: Clinical predictors and long term risk of developing type 2 diabetes: a retrospective Cohort study using survival analysis. Diabetes care. 2007;30(4):878-83.

Ferrara A, Increasing Prevalence of gestational diabetes Mellitus: a public health perspective. Diabetes care 2007 Jul;30(2):S141-S6.

Seshiah V, Balaji V, Balaji S, Sekar A, Sanjeevi, Green A. Gestational diabetes in India. J Assoc Physicians India. 2004;52:707-11.

Rajput R, Yadav Y, Nanda S, Rajput M. Prevalence of gestational diabetes Mellitus & associated risk factors at a tertiary care hospital in Haryana. Indian J Med Res. April 2013;137(4):728-33.

De Sisto CL, Kim SY, Sharma AJ. Prevalence estimates of Gestational Diabetes in the united states, Pregnancy risk Assessment Monitoring system (PRAMS), 2007 - 2010. Prev Chronic Dis. 2014 Jun 19;11.

Metzger BE, Buchanan TA, Coustan DR, De Leiva A, Dunger DB, Hadden DR, et al . Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diabetes care. 2007 Jul 1;30(2):S251-60.

van Leeuwen M, Louwerse MD, Opmeer BC, Limpens J, Serlie MJ, Reitsma JB, et al. Glucose challenge test for detecting gestational diabetes mellitus: a systematic review. BJOG: An Intern J Obstetr Gynaecol. 2012 Mar;119(4):393-401.

Salleh MM, Ardawi , Path FRC , Hassan AN, Hassan SJ, Hussein M. et al, Screening for gestational diabetes Mellitus in Pregnant females. FRCOG. Saudi M J. 2000; 21(2):155-60.

Qummry AH, Zohair JG, Amira BK, Obeid D, Mian UF. Deliveries among diabetic females; a tertiary care experience Department of Gynaecology, Alnoor Specialist hospital, Makkah, Saudi Arabia - Al Ameen J Med Sc I. 2012;5(4):407-9.

Alwan N, Tuffnell DJ, West J. Treatments for gestational diabetes. Cochrane database of systematic reviews. 2009 July 8:(3).

Benhalima K, Van Crombrugge P, Moyson C, Verhaeghe J, Vandeginste S, Verlaenen H, et al. A modified two-step screening strategy for gestational diabetes mellitus based on the 2013 WHO criteria by combining the glucose challenge test and clinical risk factors. J Clin Med. 2018 Oct;7(10):351.






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