A COMPARATIVE STUDY ON THE EFFICACY OF SINGLE STEP 75 G ORAL GLUCOSE TOLERANCE TEST WITH CARPENTER–COUSTAN CRITERIA TO DIAGNOSE GESTATIONAL DIABETES MELLITUS
Author: SRI REVATHY SADASIVAM, D. ASHA DEVI, D. VIMALA, PHILIPS ABRAHAM
Category: Clinical Sciences
Abstract:
Introduction: Prevalence of gestational diabetes mellitus (GDM) is simultaneously increasing with the global rise of diabe- sity. In the Indian context, screening is essential for all pregnant women as the Indian women have 11-fold increased risk of developing glucose intolerance during pregnancy compared to Caucasian women. Because 80-90% of women with GDM can be managed with lifestyle therapy alone, universal screening for GDM is increasingly considered justified. Various agen- cies which conduct studies on diabetes recommends two step procedure to identify GDM including oral glucose tolerance test (OGTT) which is not practical in the Indian scenario, where 70% of the population lives in rural area. In this framework, a simple one step procedure recommended by Diabetes in Pregnancy Study Group in India (DIPSI) is found to be relevant and sensible in screening and identifying the GDM cases. So, a study had been designed to identify the validity of using single step 75 g OGTT as a diagnostic tool for identifying GDM in pregnant women with no known risk factors.
Materials and Methods: 150 pregnant women (24-28 weeks of gestation) attending the antenatal clinic of Vinayaka Missions Medical College were randomly selected. Both DIPSI and Carpenter–Coustan recommended OGTT was conducted in these groups in an interval of 1-week time. Kappa agreement was used to examine the reliability of the values.
Results and Discussion: The incidence of GDM by 75 g single step OGTT was found to be 16.7%, whereas the incidence of GDM by Carpenter–Coustan method using 100 g OGTT was found to be 13.3%. This high pick up rate by 75 g OGTT may help to control the incidence of diabetes mellitus and related complications. On correlation in predicting GDM, single step 75 g OGTT was found to be 75% sensitivity and 92.3% specificity.
Conclusion: Besides being economical, high sensitivity and specificity of the single step method have affirmed the fact that it can be used as a reliable diagnostic procedure for GDM.
Keywords: Diabetes in Pregnancy Study Group in India, Gestational diabetes mellitus, Single step oral glucose tolerant test
