GESTATIONAL DIABETES MELLITUS

Gestational diabetes (GDM) is defined as “carbohydrate intolerance of variable severity with onset or first recognition during pregnancy.” The definition is applicable regardless of whether insulin is used for treatment or the condition persists after pregnancy. It does not exclude the possibility that unrecognized glucose intolerance may have antedated the pregnancy”. GDM complicates 3–15% of all pregnancies and is a major cause of perinatal morbidity and mortality, as well as maternal long term morbidity. Of all types of diabetes, gestational diabetes (GDM) accounts for approximately 90–95% of all cases of diabetes in pregnancy.

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Evaluation of “Diabetes in Pregnancy Study Group of India” (DIPSI) Criterion as a Diagnostic Test for Gestational Diabetes Mellitus

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210601 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1-5

Author(s):

Aradhana Singh ◽

Raj K Singh ◽

Vani Aditya

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Antenatal Clinic ◽

Oral Glucose ◽

Study Group ◽

Diabetes In Pregnancy ◽

Inclusion Criteria ◽

Capillary Glucose ◽

In Pregnancy

Introduction: In view of the alarmingly increasing incidence of Gestational Diabetes Mellitus (GDM), worldwide, as well as in India, a consensus to bring about standardization for diagnosis of GDM is needed. Internationally, the WHO 2013 criteria is being widely used, while (Diabetes In Pregnancy Study Group of India) DIPSI non fasting criteria is popularly used in India. There still remains many missed cases of GDM in India, which is a cause of concern. This study was done to compare the DIPSI non fasting, with WHO 2013 criteria for diagnosis of GDM. Methods: this cross-sectional study included 530 pregnant women, attending antenatal clinic of a tertiary care center, of North India, from Feb. 2018 to March 2019 and fulfilling inclusion criteria. All women attending antenatal clinic, during the study period, were subjected to capillary glucose evaluation, 2 hours after 75g oral glucose load, irrespective of the timing of last meal (DIPSI), as part of routine antenatal checkup. After 7 days, only those 530 women, who turned up in fasting state, and fulfilled inclusion criteria, were enrolled in the study and subjected to fasting 75g, oral glucose tolerance test (OGTT) (WHO 2013). Accuracy of DIPSI test was compared, to the fasting WHO 2013 criteria. Capillary glucose was measured using regular, well calibrated, point of care, “Optium Free Style” glucometer. Results: Out of 107 women diagnosed to have GDM by WHO 2013 criteria, only 89 were diagnosed by the DIPSI criteria. DIPSI had a low sensitivity (83.18%) when compared to the WHO 2013 criteria, Conclusion: This study showed that when non fasting DIPSI criteria was used as diagnostic criteria, 10.58% women with GDM, missed the diagnosis. Considering the adverse maternal and perinatal outcome of GDM, implication of missed diagnosis would be grave, especially in a developing country, like India. Hence, use of DIPSI criteria for diagnosing GDM should be reconsidered. Key words: GDM, DIPSI, OGTT, Diabetes in Pregnancy.

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Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17113767 ◽

2020 ◽

Vol 17 (11) ◽

pp. 3767 ◽

Cited By ~ 1

Author(s):

Kai Wei Lee ◽

Siew Mooi Ching ◽

Navin Kumar Devaraj ◽

Seng Choi Chong ◽

Sook Yee Lim ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Cohort Studies ◽

Pregnant Women ◽

Meta Analysis ◽

Diabetes In Pregnancy ◽

Antepartum Depression ◽

Increased Risk ◽

In Pregnancy

Previous literature has reported that patients with diabetes in pregnancy (DIP) are at risk of developing antepartum depression but the results have been inconsistent in cohort studies. We conducted a systematic review and performed a meta-analysis to quantify the association between DIP and risk of antepartum depression in cohort studies. Medline, Cinahl, and PubMed databases were searched for studies investigating DIP involving pregnant women with pre-existing diabetes and gestational diabetes mellitus and their risk of antepartum depression that were published in journals from inception to 27 December 2019. We derived the summary estimates using a random-effects model and reported the findings as pooled relative risks (RR) and confidence interval (CI). Publication bias was assessed using a funnel plot and was quantified by Egger and Begg’s tests. Ten studies, involving 71,036 pregnant women were included in this meta-analysis. The pooled RR to develop antepartum depression was (RR = 1.430, 95% CI: 1.251–1.636) among women with gestational diabetes mellitus. Combining pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus, they had a significant increased risk of developing antepartum depression (RR = 1.431, 95% CI: 1.205–1.699) compared with those without it. In comparison, we found no association between pre-existing diabetes mellitus in pregnancy (RR = 1.300, 95% CI: 0.736–2.297) and the risk of developing antepartum depression. This study has a few limitations: first, different questionnaire and cut-off points were used in evaluation of depression across the studies. Second, there was a lack of data on history of depression prior to pregnancy, which lead to confounding bias that could not be solved by this meta-analysis. Third, data were dominated by studies in Western countries; this is due to the studies from Eastern countries failing to meet our inclusion criteria for statistical analysis. Women with gestational diabetes mellitus have an increased risk of developing antepartum depression compared to those without the disease. Therefore, more attention on the mental health status should be given on pregnant women diagnosed with pre-existing diabetes mellitus and gestational diabetes mellitus.

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Emerging and Public Health Challenges Existing in Gestational Diabetes Mellitus and Diabetes in Pregnancy

Endocrinology and Metabolism Clinics of North America ◽

10.1016/j.ecl.2021.05.008 ◽

2021 ◽

Vol 50 (3) ◽

pp. 513-530

Author(s):

Yamuna Ana ◽

Shriyan Prafulla ◽

Ravi Deepa ◽

Giridhara R. Babu

Keyword(s):

Public Health ◽

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Diabetes In Pregnancy ◽

Public Health Challenges ◽

In Pregnancy

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The benefits of the use of the new International Association of Diabetes in Pregnancy Study Groups guidelines for Gestational Diabetes Mellitus

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/ajo.13215 ◽

2020 ◽

Vol 60 (5) ◽

Author(s):

David Simmons

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

International Association ◽

Study Groups ◽

Diabetes In Pregnancy ◽

In Pregnancy

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Prevalence of gestational diabetes mellitus using IADPSG and DIPSI criteria: a cross-sectional study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202320 ◽

2020 ◽

Vol 9 (6) ◽

pp. 2408

Author(s):

Trupti C. Ruge ◽

Nisha Kanchana

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

International Association ◽

Clinical Equipoise ◽

Kappa Statistics ◽

Diabetes In Pregnancy ◽

Cross Sectional ◽

Iadpsg Criteria ◽

In Pregnancy

Background: Considering the magnitude of adverse pregnancy outcomes related to gestational diabetes, the present study was undertaken to find out the prevalence of gestational diabetes mellitus using the international association of diabetes in pregnancy study groups criteria (IADPSG) and diabetes in pregnancy study group India (DIPSI) criteria to ascertain whether the present practice of diagnosing GDM by the guidelines recommended by DIPSI 21 based on WHO criterion of 2-h PG ≥140 mg/dL can still be followed in this study settings or adopt IADPSG recommendation.Methods: This study was done at Antenatal Clinic, department of obstetrics and gynecology, KLES Dr Prabhakar Kore Hospital, Belgaum from January 2013 to December 2013. A total of 225 pregnant women between 24 to 28 weeks gestations were studied. Diagnosis and the prevalence of GDM were assessed by applying both DIPSI and IADPSG criteria.Results: Most of the women (58.11%) were between 22 to 25 years and the mean age was 23.78±3.38 years. Based on the IADPSG criteria, the prevalence of GDM was 19.11% and by applying DIPSI criteria, prevalence of GDM was 16.89%. The difference in diagnostic capability between IADPSG and DIPSI was found to be 2.8% and the kappa statistics showed good strength of agreement between the two tests (p>0.302; Kappa=0.774).Conclusions: It was concluded that, the diagnosis GDM based on DIPSI is as effective as IADPSG criteria. Further, in resource poor countries like India, DIPSI procedure would be used with an advantage of being less costly and without compromising the clinical equipoise.

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