Evaluation of the diabetes in pregnancy study group of India criteria and Carpenter-Coustan criteria in the diagnosis of gestational diabetes mellitus

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.

Accuracy of screening tests for gestational diabetes mellitus in Southeast Asia

“…Of 286 studies found, 21 studies [ 14 , 16 , 33 – 51 ] met the criteria, but the data of 2 studies [ 36 , 44 ] were insufficient to be extracted resulting in a total of 19 studies [ 14 , 16 , 33 – 35 , 37 – 43 , 45 – 51 ] being included in the quantitative analyses. The flow chart of literature screening and selection process is shown in Figure 1 .…”

“…More than half were at low risk of bias and low applicability concerns in all domains. Of the 21 studies, [ 14 , 16 , 33 – 51 ] 14 studies [ 14 , 16 , 33 , 37 – 40 , 43 , 44 , 46 , 48 – 51 ] were at low risk of bias for participant selection and 7 studies [ 34 – 36 , 41 , 42 , 45 , 47 ] were at unclear risk of bias due to insufficient information of exclusion criteria. High applicability concerns of patient selection were found in four studies [ 33 , 34 , 36 , 41 ] because only women having positive index tests were tested with a reference test.…”

“…Thirteen studies [ 33 – 37 , 39 – 41 , 43 , 45 , 46 , 48 , 50 ] were at low risk of bias for the index test and eight studies [ 14 , 16 , 38 , 42 , 44 , 47 , 49 , 51 ] were at high risk of bias due to either unclearly pre-specified thresholds used or interpreting the results of the index test without being blinded. A low risk of bias for the reference standard was shown in 17 studies [ 14 , 16 , 35 , 37 – 40 , 42 – 51 ] while the other four studies [ 33 , 34 , 36 , 41 ] were at high risk because the interpretation of the reference standard results was done without being blinded. All studies [ 14 , 16 , 33 – 51 ] were judged to have only low applicability concerns for both index test and reference standard.…”

Correlation between serum 25‑OH vitamin D expression and non‑alcoholic fatty liver disease

“…Glucose in the blood is called blood sugar. The operation of various tissues and organs of the body requires glucose to provide energy (20). The normal body maintains blood glucose at a relatively stable level through hormonal regulation and nerve regulation.…”

Prevalence of Gestational Diabetes Mellitus in an Urban Indian Cohort Using Diabetes in Pregnancy Study Group in India (Dipsi) Criteria – Validating One-Step Approach

“…Timely revealing of glucose intolerance in pregnancy offers an opportunity for screening, management and prevention of GDM on time and prevents fetal complications thus improves neonatal outcomes [6,7]. This necessitates the general mandatory screening for GDM during pregnancy, which is a resource intensive testing modality.…”