Diabetes in pregnancy study group of India, the answer for gestational diabetes mellitus diagnosis dilemma: May be not!!!!

Abstract

For many years, there has been a lack of consensus over the appropriate diagnostic criteria for gestational diabetes mellitus (GDM) and the significance of the diagnosis. Multiple guidelines on diagnostic criteria across the world have complicated the diagnosis and further management of the disease, also complicating the healthcare delivery system. To compare the prevalence of GDM according to Modified Carpenter & Coustan, International association of Diabetes & Pregnancy Group (IADPSG) and DIPSI. It was cross sectional observational study, conducted at KGMU, Lucknow, Uttar Pradesh between Aug 2016 and Sept 2017. 162 patients were enrolled after fulfilling the inclusion and exclusion criteria. The study population was derived by screening pregnant females attending for their routine antenatal check up from 24 to 28 weeks of gestation. Plasma glucose levels was measured following 8hrs of overnight fasting. The pregnant females were given 82.5 glucose (equivalent to 75gm anhydrous glucose). Venous blood sample was collected for estimating plasma glucose at 0,1and 2hr. In our study the prevalence of GDM among study population according to IADPSG criteria was 22.64%, as per Modified Carpenter & Coustan criteria was 17.61% while that as per DIPSI criteria was 13.21%. Considering IADPSG criteria as gold standard DIPSI is missing 66.6% of patients diagnosed as GDM by IADPSG. Considering Modified C&C criteria as gold standard over the years DIPSI is missing 64.2% of patients diagnosed as GDM by C&C.