Evaluation of “Diabetes in Pregnancy Study Group of India” (DIPSI) Criterion as a Diagnostic Test for Gestational Diabetes Mellitus

Abstract

Introduction: In view of the alarmingly increasing incidence of Gestational Diabetes Mellitus (GDM), worldwide, as well as in India, a consensus to bring about standardization for diagnosis of GDM is needed. Internationally, the WHO 2013 criteria is being widely used, while (Diabetes In Pregnancy Study Group of India) DIPSI non fasting criteria is popularly used in India. There still remains many missed cases of GDM in India, which is a cause of concern. This study was done to compare the DIPSI non fasting, with WHO 2013 criteria for diagnosis of GDM. Methods: this cross-sectional study included 530 pregnant women, attending antenatal clinic of a tertiary care center, of North India, from Feb. 2018 to March 2019 and fulfilling inclusion criteria. All women attending antenatal clinic, during the study period, were subjected to capillary glucose evaluation, 2 hours after 75g oral glucose load, irrespective of the timing of last meal (DIPSI), as part of routine antenatal checkup. After 7 days, only those 530 women, who turned up in fasting state, and fulfilled inclusion criteria, were enrolled in the study and subjected to fasting 75g, oral glucose tolerance test (OGTT) (WHO 2013). Accuracy of DIPSI test was compared, to the fasting WHO 2013 criteria. Capillary glucose was measured using regular, well calibrated, point of care, “Optium Free Style” glucometer. Results: Out of 107 women diagnosed to have GDM by WHO 2013 criteria, only 89 were diagnosed by the DIPSI criteria. DIPSI had a low sensitivity (83.18%) when compared to the WHO 2013 criteria, Conclusion: This study showed that when non fasting DIPSI criteria was used as diagnostic criteria, 10.58% women with GDM, missed the diagnosis. Considering the adverse maternal and perinatal outcome of GDM, implication of missed diagnosis would be grave, especially in a developing country, like India. Hence, use of DIPSI criteria for diagnosing GDM should be reconsidered. Key words: GDM, DIPSI, OGTT, Diabetes in Pregnancy.