One step method for diagnosis of gestational diabetes mellitus
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 8
Abstract
To study the detection rate of gestational diabetes mellitus (GDM) with 75gm Oral glucose tolerance test (OGTT) compared with 100gm OGTT and to study the effectiveness of 75gm OGTT both as a screening as well as diagnostic test. This study was performed at the Government Medical College, Calicut, Kerala. Consecutive 500 pregnant women with gestational age between 20 and 28weeks attending the antenatal clinic were advised to do 100 gm OGTT. All of them were instructed to come after one week in an empty stomach for 75gm OGTT as recommended by WHO. Results were statistically analysed with Kappa measure of agreement. Total of 480 women underwent both 100gm OGTT and 75gm OGTT. Of the 14 women diagnosed as having GDM with 100 gm OGTT, 13 (94.8%) were positive with 75 gm OGTT which is statistically significant. Of the 447 women negative for GDM according to WHO criteria only one was found to be positive with 100gm OGTT. With 75 gm OGTT 33 women were found to be positive for GDM. The prevalence of GDM with 75 gm OGTT (6.9%) was more than twice that of 100 gm OGTT (2.9%). Diagnosis of GDM based on 75gm OGTT was found to be more economical. The two step method of screening with GCT (50gm glucose) and then diagnosing GDM based on the cut off values with 100gm OGTT is more cumbersome as the pregnant women have to visit the clinic at least twice for testing and the number of blood samples drawn is five. In this study the prevalence of GDM was 6.9% which was comparable to the recent results. Hence we suggest a single test with 75gm oral glucose and diagnosing GDM if 2 hour plasma value is >140 mg/dl as recommended by WHO.
Authors and Affiliations
K Chandramathy, N Umadevi, CH Mini, E Sulu, Neetha Sreedharan
Keywords
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