Abstract
Aim and Objectives: The present study was undertaken to find out the role and effectiveness of DIPSI guidelines as a replacement for other more time consuming and cost effective methods for detecting gestational diabetes mellitus (GDM) in the Indian population and to compare outcome between GDM and non GDM population.Methods: A total of 345 women were selected of low risk category between the gestational ages of 24 to 28 weeks and were subjected to screening for gestational diabetes by DIPSI guidelines. A 75mg oral glucose load was given irrespective of their last Meal timing followed by blood glucose estimation by glucose oxidase – peroxidase method. A report of ≥140mg/dl were labeled as GDM as per DIPSI guidelines.Results: Out of 345 subjects screened, 30 (8.7%) were positive for GDM. The false positives encountered with DIPSI were 0.57% (2/345) and another 2 cases (0.57%) were false negative by DIPSI criteria. The rate of LSCS and rate of macrosomia was significantly higher in GDM population (30% and 33.33% respectively) as compared to general population (4.4% and 2.5% respectively). In GDM group 23.3% (7) had Shoulder Dystocia compared with 0.6% (2) in the normal population. 10% were breech compared with only 0.2% in the general population with 1 IUFD requiring hysterotomy. The rates of CPD were also higher (3.3%) than the general population (1.5%). A total of 19 neonates required NICU admission of which 11 were IDM. 36.66% of IDM required NICU admission as compared to only 2.5% of the non diabetic population.Conclusions: DIPSI guidelines can use as a replacement for other more resource and time consuming and costly methods like ADA criteria for the detection of GDM in the low resource settings in developing countries.
Highlights
Gestational Diabetes Mellitus (GDM) is defined as ‘Carbohydrate intolerance with recognition or onset during pregnancy’, irrespective of the treatment with diet or insulin
DIPSI guidelines can use as a replacement for other more resource and time consuming and costly methods like American Diabetes Association (ADA) criteria for the detection of GDM in the low resource settings in developing countries
The importance of GDM is that two generations are at risk of developing diabetes in the future
Summary
Gestational Diabetes Mellitus (GDM) is defined as ‘Carbohydrate intolerance with recognition or onset during pregnancy’, irrespective of the treatment with diet or insulin. GDM is associated with maternal as well as fetal complications. The importance of GDM is that two generations are at risk of developing diabetes in the future. Women with a history of GDM are at increased risk of future diabetes, predominately type 2 diabetes, as are their children [1]. The prevalence of GDM in India varied from 3.8 to 21% in different parts of the country, depending on the geographical locations and diagnostic methods used. GDM has been found to be more prevalent in urban areas than in rural areas [2-9]. Detection and prompt treatment of GDM has been shown to reduce the risk of these complications and future health care burden on health system of the country
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