Single Step Test for Diagnosing Gestational Diabetes Mellitus

Abstract

Gestational diabetes mellitus is one of the most common medical disorders found in pregnancy. Clinical recognition of GDM is important because timely intervention by dietary measures or insulin and fetal surveillance can reduce the well described associated maternal and fetal complications. This observational study was done in PGIMS, Rohtak during period from January 2011 to December 2011. Single step test using 75 gm oral glucose was used as screening and diagnostic test for GDM. Fetomaternal outcome was studied in all the subjects. Prevalence of GDM was 7%. In Indian context with a high prevalence of GDM the Universal screening is superior to selective screening in detecting more cases, facilitating early diagnosis and associated with improved pregnancy outcome with appropriate management. Present study concurs with the WHO recommendation of 2 hours 75 gm OGTT as single step procedure for both screening as well as diagnosis of GDM. Hence, we suggest the adaptation of 75 gm glucose single step test for screening and diagnosis of GDM. How to cite this article Dahiya K, Sahu J. Single Step Test for Diagnosing Gestational Diabetes Mellitus. J South Asian Feder Obst Gynae 2014;6(2):88-92.

Screening and diagnosis of gestational diabetes in India: a systematic review and meta-analysis

“…Eleven studies reported the distribution of GDM diagnosed by gestational age [18, 26, 30, 32, 37, 39, 41, 47, 52, 56, 61]. Six studies reported the percentage of total GDM cases diagnosed in the first trimester, which ranged from 11 to 60% (Appendix S11) [18, 26, 39, 41, 47, 56].…”

“…Six studies reported the percentage of total GDM cases diagnosed in the first trimester, which ranged from 11 to 60% (Appendix S11) [18, 26, 39, 41, 47, 56]. Six studies reported the percentage of total GDM cases diagnosed before 24 weeks of gestation, which ranged from 27.5 to 54.55% [26, 30, 32, 37, 52, 61].…”

“…The most commonly observed risk factors were higher BMI (twenty-six studies [13, 20, 22, 23, 29, 30, 34, 37–39, 41–43, 45, 49, 51, 52, 55, 60, 61, 65–67, 75, 76]), older age (twenty-five studies [12, 18, 26, 30, 33, 34, 38, 39, 41–43, 46, 48–50, 52, 55, 56, 60, 66, 67, 72, 73, 75, 76]), and family history of diabetes mellitus (twenty-four studies [9, 18–21, 25, 29, 30, 33, 34, 37–39, 41, 42, 45, 46, 52, 55, 61, 66, 67, 72, 76]). Other observed risk factors include history of spontaneous abortions or stillbirths (nine studies [21, 33, 34, 39, 42, 53, 65, 66, 76]), history of macrosomia (7 studies [39, 42, 43, 45, 66, 72, 75]), multiparity (7 studies [11, 13, 39, 45, 52, 72, 76]), and higher socioeconomic status (5 studies [13] Hill, 2005 #21} […”

Comparison of Maternal and Fetal Outcomes in Parturients With and Without a Diagnosis of Gestational Diabetes

“…Furthermore, in a prospective study 20 (cases: n ¼ 35; controls: n ¼ 465), 11.4% (n ¼ 4) of the sample had their diagnosis in the initial 16 weeks, and 88.6% (n ¼ 31), in 24-28 weeks. 20,21 Miranda et al, 22 in a case-control study (cases: n ¼ 201; controls: n ¼ 201), found hypoglycemia at birth to be the most frequent complication of GD, and identified hypoglycemia and RDS as important causes of neonatal morbidity; in relation to the birth weight of the NBs, there were no statistical differences. In the present study, the mean birth weight and rate of neonatal hypoglycemia were significantly higher in infants of mothers with GD, and, when considering RDS, the same did not occur in the study by Miranda et al 21 The lower rate of RDS in our study was possibly associated with the fact that most deliveries occurred at term, with lesser chance of problems related to delayed pulmonary maturity.…”

“…20,21 Miranda et al, 22 in a case-control study (cases: n ¼ 201; controls: n ¼ 201), found hypoglycemia at birth to be the most frequent complication of GD, and identified hypoglycemia and RDS as important causes of neonatal morbidity; in relation to the birth weight of the NBs, there were no statistical differences. In the present study, the mean birth weight and rate of neonatal hypoglycemia were significantly higher in infants of mothers with GD, and, when considering RDS, the same did not occur in the study by Miranda et al 21 The lower rate of RDS in our study was possibly associated with the fact that most deliveries occurred at term, with lesser chance of problems related to delayed pulmonary maturity. 22 The proportion of cesarean sections in the present study was similar to that found in a retrospective cohort study 22 with women with GD diagnosis (n ¼ 703) in a hospital in the city of Joinville, Southern Brazil: 52.2% (n ¼ 367) had cesarean sections as the delivery route.…”