scholarly journals Gestational diabetes: know your risk by simple and single step criteria (DIPSI)

2017 ◽  
Vol 6 (11) ◽  
pp. 5107
Author(s):  
Gita Guin ◽  
Ruchita Dadhich
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Care Providers ◽  
Plasma Glucose ◽  
Single Step ◽  
Public Health Issue ◽  
Oral Glucose ◽  
Care Providers ◽  
Family History Of Diabetes

Background: Gestational diabetes mellitus (GDM) has associations beyond the index pregnancy, identifying two generations at risk of future diabetes. Thus, detection of gestational diabetes mellitus becomes an important public health issue. This study aimed to estimate the prevalence of gestational diabetes mellitus by using simple and single step DIPSI criteria (Diabetes in pregnancy study group India) and risk factors associated with GDM.Methods: This cross-sectional study was carried out in 800 antenatal patients attending the antenatal clinic. These patients have given 82.5 gm mono-hydrous (75 gm anhydrous) oral glucose irrespective of the meals and their plasma glucose was estimated at 2 hr. Patients with plasma glucose value ≥140 mg/dl were diagnosed as GDM.Results: The present study estimated that the prevalence of GDM was 14.75% at their 1st visit. We found a positive association of GDM by age, BMI, hypertension and family history of diabetes. Older women had 4.5 times greater risk of GDM than younger women, obese women had 52 times higher risk of GDM than underweight women and hypertensive pregnant women had 4 times greater risk of GDM.Conclusions: It was realized that the test (DIPSI) could be easily performed in high volume hospitals comfortably and the patient were at ease as they were not fasting. Simple, cost effective tests, if made universal and available in developing country like ours will surely aid health care providers to screen, diagnose GDM and offer preventive and treatment measures at the earliest.

scholarly journals The application of 50g oral glucose challenge test in screening for gestational diabetes mellitus in patients attending antenatal care OPD

2017 ◽  
Vol 6 (5) ◽  
pp. 1952
Author(s):  
Disha Andhiwal Rajput ◽  
Jaya Kundan Gedam
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Gestational Hypertension ◽  
Challenge Test ◽  
Oral Glucose ◽  
Average Risk ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Background: To screen patients at average risk for Gestational Diabetes using 50g Glucose Challenge test, to ascertain the prevalence of Gestational diabetes through further diagnostic testing and to prevent and manage complications. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Women with GDM are at risk for maternal and foetal complications, so it is important to screen all the pregnant woman.Methods: This study was conducted in 198 patients between 24 and 28 weeks of gestation, attending the Antenatal clinic. 50g oral glucose is administered irrespective of time of the last meal and plasma glucose is measured one hour later. Patients with plasma glucose levels more than 140 mg/dl were subjected to a 100g oral glucose tolerance test, patients with two or more abnormal reading were labelled as GDM and managed accordingly.Results: Prevalence of GDM in our study was 9.59%. Maternal complications like gestational hypertension, vaginal infections and foetal complications were much higher in GDM patients as compare to non GDM group.Conclusions: GDM is a disease which adversely affects both mother as well as foetus. It is concluded that 50 gm glucose challenge test at 24-28 weeks of gestation with a cut-off value of 140 mg/dl is a reliable screening test for GDM. This test offers the best combination of ease and economy of use and reproducibility in screening for gestational diabetes mellitus in average risk patients.

scholarly journals One step oral glucose challenge test as screening and diagnostic test for Gestational Diabetes Mellitus

2019 ◽  
Vol 14 (2) ◽  
pp. 42-45
Author(s):  
Manisha Yadav ◽  
Gehanath Baral
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Test ◽  
Challenge Test ◽  
Single Step ◽  
Oral Glucose ◽  
Fasting State ◽  
Glucose Challenge Test ◽  
Glucose Challenge

Aim: The Diabetes in Pregnancy Study Group of India (DIPSI, 2010) guidelines recommend the non-fasting 75-g oral glucose challenge test (OGCT) as a single-step screening and diagnostic test for gestational diabetes mellitus (GDM). The aim of this study was to assess the validity of DIPSI criteria by comparing with the World Health Organization (WHO) 1999 criteria of diagnosing GDM. Methods: This study was a hospital based prospective comparative study conducted among 282 pregnant women, of gestational age of 24-28 weeks attending antenatal OPD of Patan hospital. The OGCT was performed on them irrespective of fasting state and without any dietary preparation and they were again asked to come after 3 days of unrestricted carbohydrate diet in fasting state for WHO 2-hour oral glucose tolerance test (OGTT) with 75 gram of glucose load. The value of OGCT >140 mg/dl is diagnostic of GDM (DIPSI 2010). For the reliability of this test, it was compared with WHO 2-hour OGTT. Results: Among the study population, the mean age and BMI was 26.04±4.50 and 24.08±3.30 respectively. Out of 282 patients, 8 cases (2.83%) were found to have abnormal non-fasting 75-g OGCT and 4 cases (1.41%) had abnormal WHO 2-hour OGTT. Paired t test was employed to examine the difference of blood glucose level of the tests. There was statistically significant difference (p<0.001) between the tests. The Sensitivity, specificity, positive predictive value and negative predictive value of oral glucose challenge test was 25%, 97.48%, 12.5% and 98.90% respectively. The non- fasting 75-g OGCT was able to detect only 25% of the cases. Conclusions: Though the non-fasting 75-g OGCT test is cost effective and more compliant to pregnant women, the present report suggests that it cannot be used as a single step screening and diagnostic test because of its low sensitivity. However, it is an adequate alternative for screening test in resources limited areas.

scholarly journals Health Care Providers’ Perceptions of Responsibilities and Resources to Reduce Type 2 Diabetes Risk After Gestational Diabetes Mellitus

2018 ◽  
Vol 36 (2) ◽  
pp. 160-167
Author(s):  
Sumali S. Hewage ◽  
Shweta R. Singh ◽  
Claudia Chi ◽  
Jerry K.Y. Chan ◽  
Tong Wei Yew ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Care Providers ◽  
Diabetes Risk ◽  
Care Providers

scholarly journals Prevalence and cause of gestational diabetes mellitus in a tertiary care center in Kolar district: a population based study

2019 ◽  
Vol 8 (7) ◽  
pp. 2709
Author(s):  
Poojita Tummala ◽  
Munikrishna M. ◽  
Kiranmayee P.
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Tertiary Care ◽  
Oral Glucose ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.

scholarly journals GESTATIONAL DIABETES MELLITUS

2016 ◽  
Vol 23 (01) ◽  
pp. 015-019
Author(s):  
Afsheen Qazi ◽  
Amin Fahim ◽  
Aneela Qureshi3 ◽  
Mazhar ul Haque
Keyword(s):  
Diabetes Mellitus ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Oral Glucose ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Number Of Patients ◽  
History Of

Objectives: The present study was designed to find the importance of properscreening and early diagnosis of gestational diabetes mellitus. Study Design: A prospective/descriptive study Place of Study: tertiary care hospital Hyderabad. Duration of Study: fromSeptember 2014 to November 2014. Materials and Methods: A total of 168 pregnant femalesbetween the ages of 20-40 years & in their 24th to 28th week of gestation were enrolled for thestudy. Oral Glucose Tolerance Test of all the participants was done after an overnight fasting of10-12 hours. All the participants were given 75gm of glucose per 100 ml of distilled water. Theblood samples were collected after two hours time for serum glucose levels. Results: Mostof the participants were below 26 years of age 47(27.9%) with the mean age of 30.2±5.83years. However the highest prevalence of GDM was observed in age group 31-35 years (36%).Among the 25 cases of gestational diabetes mellitus the highest number of patients with GDMwere multipara (40%) followed by parity of 3-4 gravida (32%). Twenty seven women (16%)women had family history of diabetes mellitus. Among these 12/27 (44.4%) women were foundwith GDM, compared to 15/141 (10.6%) who have no family history of diabetes mellitus. Total14 (8.33%) women were found obese, out of these 8 (57%) women had GDM while only 6(42.8%) women had no GDM. Conclusion: The prevalence of GDM in the present study isfound to be 14.8%. A prevalence of GDM was higher in the elderly multiparous females whowere overweight and had family history of diabetes mellitus.

scholarly journals A Simple Index for Detection of Gestational Diabetes Mellitus

2002 ◽  
Vol 95 (9) ◽  
pp. 435-439 ◽  
Author(s):  
Rafael Perea-Carrasco ◽  
Rocio Pérez-Coronel ◽  
Rogelio Albusac-Aguilar ◽  
Manuel Lombardo-Grifol ◽  
Elena Bassas-Baena De León ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Screening Test ◽  
Positive Likelihood Ratio ◽  
Single Step ◽  
Oral Glucose ◽  
Diagnostic Efficiency ◽  
Total Proteins

The conventional screening test for gestational diabetes mellitus is measurement of plasma glucose 1 hour after 50 g glucose by mouth. The sensitivity and specificity of this test are lower than desirable; we therefore developed an index including other plasma constituents. In a preliminary study, 138 pregnant women had the standard oral glucose load screening test, and plasma fructosamine and total proteins were measured, in addition to glucose, in the 1-hour samples. An index value (I) was calculated as [fructosamine (μmol/L)÷total proteins (g/L)]×[glucose (mmol/L)÷100]. Cut-off values for I were then assessed in a second prospective study, of 642 pregnant women. Definitive diagnosis of gestational diabetes was by oral glucose tolerance test (OGTT). The index was also assessed in terms of fetal macrosomia (birthweight ≥ 4000 g). With a cut-off value of I=27.2, sensitivity was 98%, specificity 89%, diagnostic efficiency 90%, positive likelihood ratio 8.76. Application of the index would have avoided 42% of the OGTTs demanded by the standard screening test, reducing false positives from about 24% to 10%. Predictive efficacy for macrosomia was 10.3% versus 7.9%. Our index offers an efficient screening test for gestational diabetes, and with more stringent cut-off points may be applicable as a single-step diagnostic procedure.

scholarly journals The Overall Plant-based Diet Index During Pregnancy and Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 574-574
Author(s):  
Huanzhuo Wang ◽  
Li Huang ◽  
Chunrong Zhong ◽  
Renjuan Chen ◽  
Xuezhen Zhou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Smoking Status ◽  
Basic Research ◽  
Food Group ◽  
Oral Glucose ◽  
Food Groups ◽  
Family History Of Diabetes

Abstract Objectives The overall plant-based diet index (PDI) has been demonstrated to be protective against type 2 diabetes (T2D) in the general population. Whether the PDI was linked to gestational diabetes mellitus (GDM) is unclear. We aimed to assess the association of the PDI with GDM incidence in Chinese pregnant women. Methods A total of 2099 pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) were included in the present study. Dietary data were collected at 13–28 wks of pregnancy by using a validated semi-quantitative food frequency questionnaire (FFQ). Food groups including cereals, fruits, vegetables, nuts, beans, vegetable oil, dairy, eggs, meat, and fish, were ranked into quintiles and given positive (1–5 for plant food groups) or reverse (5–1 for animal food groups) scores. The PDI was obtained by summing the 10 food group scores, with a theoretical range of 10 to 50. GDM was diagnosed by the 75-g 2-h oral glucose tolerance test at 24–28 wks. Cubic-restricted spline function and logistic regression analyses were used to examine the association between the PDI during pregnancy and GDM. Results GDM was reported by 8.1% of the 2099 pregnancies. The PDI score ranged from 17 to 43 (theoretical range: 10–50), the mean (SD) was 30.2 (4.4). After adjusting for maternal age, ethnicity, education, income, parity, gravidity, family history of diabetes, total energy intake per day, and other pre-pregnancy information such as body mass index (BMI), smoking status, drinking status, exercise, and sleep quality, a linear association between the PDI and GDM risk was demonstrated by the restricted cubic splines (P for overall association = 0.024, P for nonlinearity = 0.370). Compared to the lowest quartile 1 of PDI, ORs (95% CI) were 0.91 (0.59, 1.42) for quartile 2, 0.91 (0.58, 1.41) for quartile 3, and 0.52 (0.30, 0.89) for quartiles 4 (P for trend = 0.040) in the adjusted model. Conclusions Our study suggests that higher PDI is associated with a substantially lower risk of developing GDM, which indicates that adopt plant-based diets during pregnancy could be an easy avenue to reduce GDM risk. Funding Sources Funding was received from the National Program on Basic Research Project of China (NO.2013FY114200) and the Fundamental Research Funds for the Central Universities (HUST2016YXZD040) for Nianhong Yang.

scholarly journals A Prospective Evaluation of Point-of-Care Measurements of Maternal Glucose for the Diagnosis of Gestational Diabetes Mellitus

2020 ◽  
Vol 66 (2) ◽  
pp. 316-323 ◽  
Author(s):  
Eimer G O’Malley ◽  
Ciara M E Reynolds ◽  
Ruth O’Kelly ◽  
Anne Killalea ◽  
Sharon R Sheehan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Regression Analysis ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Plasma Glucose ◽  
Point Of Care ◽  
Oral Glucose ◽  
Regression Equations ◽  
Capillary Glucose ◽  
Maternal Glucose

Abstract Background Point-of-care (POC) measurement of glucose is currently recommended only for the monitoring of gestational diabetes mellitus (GDM). This prospective observational study evaluated the use of POC measurements of maternal glucose to diagnose GDM in women being screened selectively with a 1-step 75 g oral glucose tolerance test (OGTT). Methods The strictest preanalytic and analytic international laboratory standards were applied to measure maternal plasma glucose at fasting and at 1 and 2 h post glucose load. The recent International Association of Diabetes and Pregnancy Study Groups diagnostic criteria were used. At the same time, maternal capillary glucose was measured. Because of differences in plasma and capillary glucose measurements, regression analysis of POC capillary glucose results vs laboratory plasma glucose results was conducted. The regression equations for plasma glucose were derived in a derivation cohort (n = 102). These equations were applied in the validation cohort (n = 100). Predicted and actual plasma glucose values were compared. Results Of the 202 women screened, 36.6% were nulliparous, 56.4% were obese, and 81.2% were Irish-born. Two thirds had a single risk factor for GDM, and a third had multiple risk factors. Based on the plasma measurements, 53.5% had GDM. As a predictor of GDM, the diagnostic accuracy of POC measurement was 83.0% (95% confidence interval, 74.2–89.8). Conclusions In high-resource settings where measures to inhibit glycolysis are implemented, the use of POC measurements for the diagnosis of GDM is not justified based on this study. In low- and medium-resource settings, where measures to inhibit glycolysis are not achievable, regression analysis using POC measurements may be acceptable compared with plasma samples subject to glycolysis.

scholarly journals Prospective of study of gestational diabetes mellitus risk in relation to maternal recreation physical activity before and after pregnancy

2018 ◽  
Vol 6 (8) ◽  
pp. 2785
Author(s):  
Sukesh R. S. ◽  
Laxmy Rajmohan
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Challenge Test ◽  
Control Group ◽  
Case Group ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
Pregnant Females

Background: Gestational diabetes mellitus is common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. The present study aimed to know association between physical activity and gestational diabetes mellitus in the first 20 weeks of their pregnancy.Methods: In the current case-control study, 50 pregnant females with gestational diabetes mellitus as the case group and 50 pregnant females as control group were selected. To diagnose gestational diabetes mellitus using diagnostic criteria. Females with abnormal oral glucose challenge test (>140mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by pregnancy physical activity questionnaire. Anthropometric and other data were recorded for all of the participants.Results: Females with low total physical activity at early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus compared to the ones with higher levels of physical activity. After adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. Females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus compared to females with a higher intensity of sedentary, light and moderate physical activity.Conclusions: Females should be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it. 

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