Abstract

Objective:Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance that is diagnosed for the first time during pregnancy. This prospective study was undertaken to validate the single-step non-fasting 75 gm Diabetes in Pregnancy Study Group of India (DIPSI) criteria of GDM in Indian patients in comparison with the two-step fasting 100 gm glucose challenge through the Carpenter Coustan criteria (CCC).Materials and Methods:Two hundred patients underwent comparative testing using the DIPSI criteria and CCC. Plasma venous blood glucose levels were estimated using the hexokinase method; values ≥140 mg/dL at 2 hours were considered positive according to the DIPSI criteria. Any two values from ≥95 mg/dL for fasting, ≥180 mg/dL at 1 hour, ≥155 mg/dL at 2 hours, and ≥140 mg/dL at 3 hours were considered positive with the CCC.Results:The mean age and body mass index were 24.26±3.75 years and 20.7±3.07 kg/m2. The sensitivity, specificity, and positive and negative predictive values of the DIPSI guidelines were found as 100%, 97.14%, 83.87%, and 100%, respectively. The positive and negative likelihood ratios were 35.8 and zero. Diagnostic accuracy was found as 97.56%.Conclusion:DIPSI having high sensitivity, specificity, negative predictive value and diagnostic accuracy. DIPSI offers simplicity, feasibility, convenience, and repeatability while economizing universal screening and diagnosis of GDM on a mass-scale. The DIPSI procedure has the potential to be applied to the entire obstetric population, in the implementation of public health programs to diagnose GDM in the community, thus reaching the needs of the developing world.

Highlights

  • Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance that is diagnosed for the first time during pregnancy, irrespective of treatment with diet or insulin[1,2]

  • The sensitivity, specificity, and positive and negative predictive values of the Diabetes in Pregnancy Study Group of India (DIPSI) guidelines were found as 100%, 97.14%, 83.87%, and 100%, respectively

  • Of the 200 women, 31/200 (15.5%, 95% confidence intervals (CI): 10.93-21.44) tested positive with the DIPSI criteria, and 26/200 (10.5%, 95% CI: 6.77-15.81) tested positive in the 100 gm oral glucose tolerance test (OGTT) as per the Carpenter Coustan criteria (CCC)

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Summary

Introduction

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance that is diagnosed for the first time during pregnancy, irrespective of treatment with diet or insulin[1,2]. The Diabetes in Pregnancy Study Group of India (DIPSI) criteria are a major breakthrough because they cater for the screening and diagnosis of all pregnant women irrespective of fasting state through a simple, economical, and convenient single-step procedure with a 75 g 2 hour glucose test with a cut-off point of >140 mg/dL for diagnosis. This prospective study was undertaken to validate the single-step non-fasting 75 g DIPSI criteria of GDM in Indian patients in comparison with the two-step fasting 100 g OGTT with the CCC[14]

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