Screening for Gestational Diabetes by DIPSI Guidelines

  • Aditi Phulpagar Assistant Professor, Department of Obstetrics and Gynaecology, KB Bhabha Hospital, RK Patkar Marg, Bandra West, Mumbai – 400050
  • Prasad Deshmukh Assistant Professor, Department of Obstetrics and Gynaecology, LTM Medical College and Hospital, Sion Mumbai- 400022
  • Anurag Gunderia Consultant Obstetrician and Gynaecologist, Nirmal Polyclinic and Nursing Home, Worli, Mumbai- 400018
Keywords: Gestational Diabetes Mellitus (GDM), DIPSI guidelines, ADA, MNT, Macrosomia, Perinatal outcome

Abstract

Aim and Objectives: The present study was undertaken to find out the role and effectiveness of DIPSI guidelines as a replacement for other more time consuming and cost effective methods for detecting gestational diabetes mellitus (GDM) in the Indian population and to compare outcome between GDM and non GDM population.

Methods: A total of 345 women were selected of low risk category between the gestational ages of 24 to 28 weeks and were subjected to screening for gestational diabetes by DIPSI guidelines. A 75mg oral glucose load was given irrespective of their last Meal timing followed by blood glucose estimation by glucose oxidase – peroxidase method. A report of ≥140mg/dl were labeled as GDM as per DIPSI guidelines.

Results: Out of 345 subjects screened, 30 (8.7%) were positive for GDM. The false positives encountered with DIPSI were 0.57% (2/345) and another 2 cases (0.57%) were false negative by DIPSI criteria. The rate of LSCS and rate of macrosomia was significantly higher in GDM population (30% and 33.33% respectively) as   compared to general population (4.4% and 2.5% respectively). In GDM group 23.3% (7) had Shoulder Dystocia compared with 0.6% (2) in the normal population. 10% were breech compared with only 0.2% in the general population with 1 IUFD requiring hysterotomy. The rates of CPD were also higher (3.3%) than the general population (1.5%). A total of 19 neonates required NICU admission of which 11 were IDM. 36.66% of IDM required NICU admission as compared to only 2.5% of the non diabetic population.

Conclusions: DIPSI guidelines can use as a replacement for other more resource and time consuming and costly methods like ADA criteria for the detection of GDM in the low resource settings in developing countries.

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Published
2018-04-01
Section
Original Research Articles