Screening of gestational diabetes mellitus using one-step versus two-step method: a comparative study

Deepti Khenwar, Juhi Agarwal, Sushruta Shriastava


Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.

Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).

Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. Out of 305 non high-risk pregnant women, 9 (2.95%) were positive for GDM by OGTT and 10 (3.27%) were positive by DIPSI.

Conclusions: Present study concludes that DIPSI is the test which can predict GDM in population comparable to another test like OGTT. Also, India’s major population reside in rural areas, ANC are mostly conducted by ANM, therefore screening test should be easy to perform and interpret.


Diabetes in pregnancy study group of India, Gestational diabetes mellitus, Oral glucose tolerance test, One step method, Two step method

Full Text:



Metzger BE, Coustan DR. Summary and recommendations of the fourth international workshop-conference on gestational diabetes mellitus. The Organizing Committee. Diabetes Care. 1998;21(Suppl 2):B161-7.

Seshiah V, Balaji V, Balaji MS, Pannerselvam A, Arthi T, Thamilarasi M, et al. Prevalence of GDM in South India (Tamilnadu). A community based study. J Assoc Physicians India. 2008;56:329-33.

Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Arthi T, Thamizharasi M, et al. Gestational diabetes mellitus in all trimesters of pregnancy. Diabetes Research Clin Prac. 2009;77:482-4.

Seshiah V. Fifth national conference of diabetes in pregnancy study Group, India. J Assoc Physicians India. 2010;58:329-0.

Xu X, Liu Y, Liu D, Li X, Rao Y, Sharma M, Zhao Y. Prevalence and determinants of gestational diabetes mellitus: a cross-sectional study in China. Int J Environ Res Public Health. 2017;14(12):1532.

Jiwani A, Marseille E, Lohse N, Damm P, Hod M, Kahn JG. Gestational diabetes mellitus: results from a survey of country prevalence and practices. The J Maternal-Fetal Neonat Med. 2012;25(6):600-10.

Sevket O, Ates S, Uysal O, Molla T, Dansuk R, Kelekci S. To evaluate the prevalence and clinical outcomes using a one-step method versus a two-step method to screen gestational diabetes mellitus. The J Maternal-Fetal Neonat Med. 2014;27(1):36-41.

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.

Balaji V, Balaji M, Anjalakshi C, Cynthia A, Arthi T, Seshiah V. Diagnosis of gestational diabetes mellitus in Asian-Indian women. Indian J Endocr Metab. 2011;15:187-90.

de Aguiar LG, de Matos HJ, de Brito Gomes M. Could fasting plasma glucose be used for screening high-risk outpatients for gestational diabetes mellitus ? Diabetes Care. 2001;24:954-5.

Mohan V, Mahalakshmi MM, Bhavadharini B, Maheswari K, Kalaiyarasi 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.

Jowett NI, Samanta AK, Burden AC. Screening for diabetes in pregnancy: is a random blood glucose enough? Diabet Med. 1987;4:160-3.

Sermer M, Naylor CD, Farine D, Kenshole AB. The Toronto tri-hospital gestational diabetes project: A preliminary review. Diabetes care. 1998;21:B33.