Comparative Evaluation of Diabetes in Pregnancy Study Group of India and International Association of Diabetes and Pregnancy Study Groups: Criteria for the Diagnosis of Gestational Diabetes Mellitus

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a glucose tolerance disorder that occurs or is diagnosed for the first time during pregnancy. GDM affects 1–14% of all pregnancies, and its incidence has been steadily rising. GDM is a major cause of perinatal morbidity and mortality, as well as maternal morbidity. It is therefore highly important that these mothers are diagnosed during pregnancy and that they have a regular postpartum follow-up for identification and treatment of any complications. Materials and methods: All antenatal women attending the antenatal clinic (ANC) at 24–28 weeks of pregnancy were included in the study. After obtaining history, detailed examination, and informed consent, 2 mL of blood sample was taken in fluoride vial under all aseptic precautions in nonfasting state and after giving 75 g oral glucose load. Blood sugar levels were assessed in the obtained samples. All those women having blood sugar levels >140 mg/dL were categorized as GDM as per the Diabetes in Pregnancy Study Group of India (DIPSI) criteria. Same women were called again after 3–4 days in fasting state. First, 2 mL of the sample was taken in fasting state and then after giving oral glucose load of 75 g. Samples were taken after 1 and 2 hours consecutively. All those women who are having any single plasma glucose values above or equal to the cutoff, fasting: ≥92 mg/dL, 1-hour: ≥180 mg/dL, and 2-hour: ≥153 mg/dL were categorized GDM as per the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria 6: the data so collected were subjected to the analysis using SPSS version 21; power of the study was taken as 80%. Vitros GLU Slide method was used for blood sugar estimation. Chi-square test and Student’s t-test were used to test the significance of two means. Level of significance was significant at p ≤ 0.05. Result: Sensitivity of DIPSI is quite low, hence to be used as screening and diagnostic tool at the same time is still questionable. A repeat DIPSI at 32–34 weeks may increase its sensitivity. Even if we are using DIPSI for the diagnosis of GDM, the 2-hour capillary blood glucose (CBG) cutoff should be lowered than 140 mg/dL for good sensitivity of the test. Conclusion: Doctor’s counseling and motivation are the best drives to bring mothers in fasting state and can make IADPSG too a simple and cost-effective single-step method in our country. This is the dire requirement of our country to have a better sensitive method for diagnosing GDM so that healthcare facility does not crunch out because of additional false-positive cases detected by DIPSI.