Can single plasma glucose value 2 hours after 75g glucose (DIPSI criteria) replace the gold standard OGTT for the diagnosis of gestational diabetes mellitus?

摘要

Background: Gestational diabetes mellitus is a common medical complication of pregnancy associated with several fetal and maternal complications. There are several screening tools for detecting gestational diabetes mellitus including recent DIPSI criteria of non-fasting single plasma 2-hour value after 75 grams glucose (single step test). The present study was aimed at calculating prevalence of GDM, sensitivity and specificity using non-fasting single plasma 2-hour value after 75 grams glucose for screening and diagnosis of gestational diabetes mellitus and to study the high-risk characteristics for GDM in this study population. Methods: This was a prospective study conducted for a period of one year. 750 antenatal women attending Antenatal outpatient department(OPD) with period of gestation 24-28 weeks were enrolled in the study. All women were first tested by 75 gm glucose and then by OGTT for confirmation. Prevalence rates, sensitivity, specificity, positive predictive value and negative predictive value were studied. History based questionnaire was used to study the risk characteristics for GDM. Results: Prevalence rate, sensitivity, specificity, positive predictive value and negative predictive value for patients were 14.13%, 73.58%, 95.03%, 70.90% and 95.67%. Among the risk factors 7.2% patients were more than 30 years in age. 0.93% had GDM in previous pregnancy.4.21% had GCA in previous pregnancy, 12.4% had SB/IUD/NND in previous pregnancy. 1.17% had previous pregnancy with birth weight more than 3.5 kg and 9.73% had family history of diabetes mellitus. Past history of GDM (50%) was the most common risk factor in GDM group followed by age 30 years (29.6%), and family history (24.6%). Conclusions: Screening using DIPSI criteria has good sensitivity and negative predictive values. It can serve as both screening and diagnostic test besides being simple, user friendly, cost effective and evidence-based test in less resource countries like India.