The Validity of One Step 75 Grams Oral Glucose Challenge Test for Universal Screening of Gestational Diabetes Mellitus: A Prospective Study

Abstract

Background- Diabetes mellitus (GDM) is the most common metabolic disorder in pregnant women and is characterized by carbohydrate intolerance of variable severity with onset or first recognition during pregnancy regardless of glycemic status after delivery .There has been a recent trend in increase in Type 2 diabetes mellitus in Asia which is well documented. The increase seems to be greater in South Asian region as compared to East and South East Asia. The validity of 75 gram 2 hours Glucose Challenge Test as a diagnostic tool is not well established. Therefore, present study was undertaken to evaluate the validity of 75 gram 2 hours Glucose Challenge Test as a diagnostic test.Methodology- This study included 100 women with gestational age between 24th and 28th weeks, attending antenatal care (ANC) clinic at a tertiary care hospital in Delhi. Women who had given the consent to participate were given a standardized 2-h 75 g oral glucose tolerance test (OGTT). Then they were asked to come after a week on an empty stomach for 100g oral glucose tolerance test recommended by Carpenter Couston. Venous blood will be drawn in the fasting state, 1hr, 2hr & 3hr.Results- Prevalence of GDM was found 19% and 75 gram Glucose Challenge Test is a highly sensitive (100%) and specific (98.7%) test which has a very high positive (95%) and negative (100%) predictive value.Conclusion- Country like India, where antenatal visits and follow-ups are not very regular, this test is an important single step screening for gestational diabetes mellitus (GDM). The present study concludes that 75-gms GCT is an easy, economical as well as less cumbersome procedure. It is a patient-friendly approach because it is performed irrespective of the last meal and patient need not to come fasting. Patient needs to come once for this test. So this test can be utilized for screening purpose.