DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20200857

Retrospective study on assessment of risk for gestational diabetes using fetal medicine foundation’s gestational diabetes risk assessment calculator in a tertiary care hospital in coastal Karnataka, India

Pradeep Ganiga, Vivek V. Subhash

Abstract


Background: Gestational diabetes is defined as impaired glucose tolerance with onset or first recognition during pregnancy. Undiagnosed or inadequately treated gestational diabetes can lead to significant maternal and fetal complications. Even though there are guidelines for diagnosis of GDM (gestational diabetes mellitus) by the Government of India, there is poor penetration of the implementation throughout the nation.

Methods: The study was conducted in A. J. Institute of Medical Sciences between April to June 2019. 56 patients were evaluated with the fetal medicine foundation GDM risk calculator to assess the risk for gestational diabetes in a retrospective approach.

Results: Incidence of GDM in the study was 15.9%. At a cut-off of 1/80, the calculator predicted increased risk for 37 out of 56 patients. There was a sensitivity of 91.6% and specificity of 63.6% with a negative predictive value of 96.5% and positive predictive value of 29.5%. there was a false positive rate of 43.2%.

Conclusions: The fetal medicine foundation GDM risk calculator will prove to be an invaluable tool to predict high risk patients who need closer monitoring of blood glucose into the third trimester.


Keywords


Fetal medicine foundation, Gestational diabetes, Risk calculator

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References


National Health Mission Ministry of Health and Family Welfare, “diagnosis and management of gestational diabetes mellitus”. Natl Heal Mission Minist Heal Fam Welf. 2018;1-2.

Farrar D, Duley L, Dowswell T, Lawlor DA. Different strategies for diagnosing gestational diabetes to improve maternal and infant health. Cochrane Database Syst Rev. 2017;8:2017.

KC K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab. 2015;66(2):14-20.

Mishra S, Bhadoria A, Kishore S, Kumar R. Gestational diabetes mellitus 2018 guidelines: An update. J Fam Med Prim Care. 2018;7(6):1169-72.

Syngelaki A, Pastides A, Kotecha R, Wright A, Akolekar R, Nicolaides KH. First-trimester screening for gestational diabetes mellitus based on maternal characteristics and history. Fetal Diagn Ther. 2015;38(1):14-21.

World Health Organization. Report of a WHO/IDF Consultation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. Available at: https://www.who.int/diabetes/publications/ diagnosis_diabetes2006/en. Accessed 15th January 2020.

Rani PR, Begum J. Screening and diagnosis of gestational diabetes mellitus, where do we stand. J Clin Diagnostic Res. 2016;10(4):QE01-QE04.

Cheng AYY, Cheng AYY. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2013;37:S1-S3.

International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676-82.

Seshiah V, Balaji V, Balaji MS, Sekar A, Sanjeevi CB, Green A. One step procedure for screening and diagnosis of gestational diabetes mellitus. J Obs Gynecol India. 2005;55(6):525-9.

Xiang AH, Li BH, Black MH, Sacks DA, Buchanan TA, Jacobsen SJ, Lawrence JM. Racial and ethnic disparities in diabetes risk after gestational diabetes mellitus. Diabetol. 2011;54(12):3016-21.

Zheng T, Ye W, Wang X, Li X, Zhang J, Little J, et al. A simple model to predict risk of gestational diabetes mellitus from 8 to 20 weeks of gestation in Chinese women. BMC Preg Childbirth. 2019;19(1):252.

Karaçam Z, Çelİk D. The prevalence and risk factors of gestational diabetes mellitus in Turkey: a systematic review and meta-analysis. J Matern Neonatal Med. 2019:1-11.

Caliskan E, Kayikcioglu F, Ozturk N, Koc S, Haberal A. A population-based risk factor scoring will decrease unnecessary testing for the diagnosis of gestational diabetes mellitus. Acta Obstet Gynecol. Scand. 2004;83(6):524-30.

Nanda S, Savvidou M, Syngelaki A, Akolekar R, Nicolaides KH. Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks. Prenat Diagn. 2011;31(2):135-41.

Kaira S. P-68 ‘Late onset’ gestational diabetes mellitus (LO-GDM): distinct cohort. Diabetes Res. Clin Pract. 2008;79:S80.

Naylor CD, Sermer M, Chen E, Farine D. Selective screening for gestational diabetes mellitus. N Engl J Med. 1997;337(22):1591-6.

Teede HJ, Harrison CL, The WT, Paul E, Allan CA. Gestational diabetes: development of an early risk prediction tool to facilitate opportunities for prevention. Aust New Zeal J Obstet Gynaecol. 2011;51(6):499-504.

Van Leeuwen M, Opmeer BC, Zweers EJ, Van Ballegooie E, Ter Brugge HG, De Valk HW, et al. Estimating the risk of gestational diabetes mellitus: a clinical prediction model based on patient characteristics and medical history. An Inter J Obstet Gynaecol. 2010;117(1):69-75.