Comparative Study of DIPSI and WHO (2018) Criteria for Diagnosis of Gestational Diabetes Mellitus

Abstract

BACKGROUND
 Gestational diabetes mellitus is defined as carbohydrate intolerance with onset/recognition during pregnancy. There is an increase in incidence worldwide with a range of 0.4 - 10 %. Gestational Diabetes is often asymptomatic and associated with increased foetal and neonatal morbidity and mortality. Over the years there have been many controversies regarding the best screening and diagnostic test for GDM. The testing for GDM by appropriate method at the earliest detects women who need treatment with either diet alone or a combination of diet with insulin therapy. This helps in the prevention of maternal morbidity and mortality. Hence, an appropriate screening test for GDM has been much emphasized. This study was done to compare the non-fasting diabetes in pregnancy study group of India (DIPSI) criteria with the fasting state of the WHO 2018 for the diagnosis of GDM in our hospital setting.
 METHODS
 With this background, we conducted a single centric, prospective, observational study in our tertiary care hospital, after obtaining permission from the Institutional Ethics Committee. In this study, we enrolled 200 patients attending obstetric OPD in Basaveshwar teaching and general hospital and Sangameshwar hospital attached to Mahadevappa Rampure Medical College, Kalaburagi with gestational age 24 – 28 weeks as per the inclusion and exclusion criteria. All participants were then subjected to screening and diagnostic tests as per DIPSI and WHO 2018 criteria.
 RESULTS
 Prevalence of GDM was 12.5 % in WHO 2018 group when compared to 10.5 % in the DIPSI group. The specificity of the DIPSI method in detecting GDM was 98 %. The highest incidence of GDM was observed in the age group of 26-30 yrs. Incidence of the highest prevalence of GDM was observed with BMI > 25 kg/m2. We studied the co-relation between GDM with DIPSI and WHO 2018. True positive 16, False Negatives 9, True Negatives 179, False Positive 05.
 CONCLUSIONS
 Screening with DIPSI has 98 % specificity compared. DIPSI being a one-step procedure offers both a screening and diagnostic test for GDM. It avoids the need for multiple hospital visits, and multiple blood samples.