Efficacy of Diabetes in Pregnancy Study Group India as a Diagnostic Tool for Gestational Diabetes Mellitus in a Rural Setup in North India

Samar Rudra; Ashu Yadav

doi:10.5005/jp-journals-10006-1731

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Efficacy of Diabetes in Pregnancy Study Group India as a Diagnostic Tool for Gestational Diabetes Mellitus in a Rural Setup in North India

Samar Rudra, Ashu Yadav

Keywords : Diabetes in Pregnancy Study Group India, Gestational diabetes mellitus, International Association of the Diabetes and Pregnancy Study Group, World Health Organization

Citation Information : Rudra S, Yadav A. Efficacy of Diabetes in Pregnancy Study Group India as a Diagnostic Tool for Gestational Diabetes Mellitus in a Rural Setup in North India. J South Asian Feder Obs Gynae 2019; 11 (6):349-352.

DOI: 10.5005/jp-journals-10006-1731

License: CC BY-NC 4.0

Published Online: 25-02-2013

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Abstract

Objective: To study the efficacy of Diabetes in Pregnancy Study Group India (DIPSI) as a diagnostic tool for gestational diabetes mellitus (GDM). Introduction: A simple, convenient, and patient-friendly method of diagnosing GDM by DIPSI criteria has been questioned by many workers. Hence, this study was undertaken to compare DIPSI to gold standard International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria to determine diagnostic accuracy of DIPSI. Materials and methods: This cross-sectional study was conducted in the department of obstetrics and gynecology in a rural medical college in North India. It included 800 pregnant women with gestational age 24–28 weeks, who underwent plasma glucose (PG) evaluation 2 hours after the challenge of 75 g glucose load irrespective of their fasting state (DIPSI criteria for GDM). After 7 days, standard 75 g OGTT was done in all women irrespective of previous PG value. Blood glucose was tested by glucose oxidase peroxidase method. Accuracy of the DIPSI result was compared with OGTT using cutoffs as per standard criteria for the diagnosis of GDM. Results: Of all 800 cases, 48 cases either did not report for the second visit in time or could not tolerate oral glucose. Of the remaining 752 cases analyzed, 620 cases found to be normal both by DIPSI and IADPSG criteria, 81 patients detected to have GDM by both criteria. In 30 patients, DIPSI detected GDM, but IADPSG criteria values were within normal limit. A total of 21 patients found to be GDM by IADPSG criteria, but DIPSI values were within normal limit. When compared with IADPSG, DIPSI found to have a sensitivity of 79.41%, specificity of 95.39%, positive predictive value of 72.97%, negative predictive value of 96.73%, and diagnostic accuracy of 93.23%. Conclusion: In conclusion, DIPSI method of screening antenatal women for GDM is found to be simple, cost-effective, easy to perform, patientfriendly, and convenient. On comparing results to gold standard IADPSG, DIPSI shows high specificity and acceptable sensitivity. A statistical analysis has shown that if a cutoff value of blood sugar is lowered to 136 from 140, the sensitivity and specificity of DIPSI criteria improve further.

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