scholarly journals Comparative study of DIPSI and IADPSG criteria for diagnosis of GDM

Author(s):  
Swathy Srinivasan ◽  
Rani P. Reddi

GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The prevalence of GDM varies, widely based on the diagnostic criteria used and the ethnic group studied. It is associated with adverse maternal and perinatal outcome. Incidence of GDM in India is 1-14%. There are several screening and diagnostic tests for GDM. It is important to diagnose early and treat to prevent these complications. The present study was done to compare Diabetes in Pregnancy Study Group India (DIPSI) with International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for diagnosis of GDM and to assess the validity of these methods.Methods: It was a cross sectional study done in 144 pregnant women who fulfilled the inclusion criteria. They underwent non - fasting OGTT with 75 grams glucose which was given irrespective of the last meal. A venous blood sample was drawn two hours after glucose administration. They were advised to come two to three days later and repeated with 75 grams OGTT after an overnight fast of atleast 8 hours. Venous blood sample was drawn at fasting, one hour and two hours after load with 75 grams of glucose. Plasma glucose was measured by using an autoanalyzer by glucose - oxidase peroxidase (GOD - POD) technique.Results: The epidemiological parameters like Age, BMI, Parity and Gestational age did not have any difference between two groups. 17.4% was diagnosed by DIPSI criteria and 15.3% was diagnosed by IADPSG criteria and 6.9% was diagnosed by both. Sensitivity and specificity of DIPSI was 45% and87% and sensitivity and specificity of IADPSG was 40% and89% respectively. According to kappa statistics, the p-value is 0.000.Conclusions: In present study it was concluded that screening is very essential in all pregnant women due to high prevalence of GDM in India. By comparing these two criteria, sensitivity of DIPSI was found better than IADPSG criteria in diagnosing GDM. Though IADPSG is universally accepted for diagnosis, DIPSI has still got a place in low resource countries as it is easy, cost effective and non fasting test.

Author(s):  
Muna Kh. Al-kubaisi ◽  
Saad M. Al-Shibli ◽  
Nilar Win

Aim: Is to find the mean and two standard deviation of the serum blood sugar among pregnant women while running the modified oral glucose tolerance test (MOGTT) as screening for gestational diabetes mellitus (GDM) & to compare the readings with other protocols adopted in diagnosing GDM. Method: A cross sectional study among pregnant women running routine MOGTT at 24-28 weeks’ gestation. A total of 149 women participated in 4 months period. The test included 5 ml of venous blood sample taken after fasting for 8 hours and a second blood sample 2 hours after having 200 ml of 75 g glucose solution within 10 minutes. Results: The mean for the fasting blood sugar is 4.32 mmol/L±0.52 making value of 2SD of 5.36 mmol/l. The mean of the 2 hours glucose level was 6.11mmol/l±1.38 making the 2SD value of 8.87 mmol/l. Conclusion: Our results for the 1st reading in MOGTT is near to the value of the local protocol in diagnosing GDM. The 2 hours postprandial reading in the local protocol is fairly low when compared with our findings & with guidelines of nearby communities.


BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035632 ◽  
Author(s):  
Heidi Hopkins ◽  
Quique Bassat ◽  
Clare IR Chandler ◽  
John A Crump ◽  
Nicholas A Feasey ◽  
...  

IntroductionFever commonly leads to healthcare seeking and hospital admission in sub-Saharan Africa and Asia. There is only limited guidance for clinicians managing non-malarial fevers, which often results in inappropriate treatment for patients. Furthermore, there is little evidence for estimates of disease burden, or to guide empirical therapy, control measures, resource allocation, prioritisation of clinical diagnostics or antimicrobial stewardship. The Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study seeks to address these information gaps.Methods and analysisFIEBRE investigates febrile illness in paediatric and adult outpatients and inpatients using standardised clinical, laboratory and social science protocols over a minimum 12-month period at five sites in sub-Saharan Africa and Southeastern and Southern Asia. Patients presenting with fever are enrolled and provide clinical data, pharyngeal swabs and a venous blood sample; selected participants also provide a urine sample. Laboratory assessments target infections that are treatable and/or preventable. Selected point-of-care tests, as well as blood and urine cultures and antimicrobial susceptibility testing, are performed on site. On day 28, patients provide a second venous blood sample for serology and information on clinical outcome. Further diagnostic assays are performed at international reference laboratories. Blood and pharyngeal samples from matched community controls enable calculation of AFs, and surveys of treatment seeking allow estimation of the incidence of common infections. Additional assays detect markers that may differentiate bacterial from non-bacterial causes of illness and/or prognosticate illness severity. Social science research on antimicrobial use will inform future recommendations for fever case management. Residual samples from participants are stored for future use.Ethics and disseminationEthics approval was obtained from all relevant institutional and national committees; written informed consent is obtained from all participants or parents/guardians. Final results will be shared with participating communities, and in open-access journals and other scientific fora. Study documents are available online (https://doi.org/10.17037/PUBS.04652739).


2021 ◽  
Author(s):  
Ejlal Omer FadlElseed ◽  
Khalid Abdelsamea Mohamedahmed ◽  
Aboagala Mustafa Mohamed ◽  
Muatez Ibrahim Hassan ◽  
Yousif E/Hameed Mohammed ◽  
...  

Abstract Background: Preeclampsia is considered one of the major health problems associated with pregnancy and one of the causes of maternal mortality. The pathogenesis of preeclampsia associated with platelet activation.Methods: This is a case-control laboratory-based study carried out in Wad Medani Obstetrics and Gynecology Teaching Hospital, Gezira State, Sudan from January to November 2020. The study aimed to evaluate the platelet parameters (platelet count and platelet indices) in pregnant women with preeclampsia. A total of 50 pregnant women with preeclampsia as cases (32.20 ± 3.21 years) and 50 normotensive pregnant women as controls (30.68 ± 2.85 years) participated in this study. Three ml of venous blood samples were collected from all participants in K3 EDTA containers. platelet parameters (platelet count and platelet indices) were determined using Mindray BC 3000 Automated Hematology Analyzer. Data were analyzed using the SPSS computer program (version 22). Results: The study results showed that the thrombocytopenia account for 56 %, all cases with low PCT (100%). Furthermore the means of PLTs count, PCT and PDW in cases were (144.40 ± 31.80 × 109/L, 0.13 ± 0.03 % and 15.80 ± 0.45 fl respectively) versus controls (269.40 ± 72.50 × 109/L, 0.22 ± 0.05 % and 15.50 ± 0.29 fl respectively), giving statistically significant differences (P value = 0.000, 0.003 and 0.022 respectively). The mean of PCT of mild cases was lower than severe cases (P value = 0.004); but there were no significant differences in PLTs count, MPV and PDW (P value = 0.379, 0.283 and 0.075 respectively).Conclusion: The study concluded that platelet count (PLTs count) and plateletcrit (PCT) were significantly decreased in pregnant women with preeclampsia especially; so platelet parameters especially (PLTs count and PCT) should be included for assessing and predicting the risk of severe preeclampsia.


2021 ◽  
Vol 5 (2) ◽  

Background: Preeclampsia is considered one of the major health problems is associated with pregnancy and one of the causes of maternal mortality. The pathogenesis of preeclampsia associated with platelets activation. Objectives: The aim of this study was to evaluate the platelets parameters (platelet count and platelet indices) in pregnant women with preeclampsia. Methodology: This is a case-control laboratory-basedstudy carried out in Wad Medani Obstetrics and Gynecology Teaching Hospital, Gezira State, Sudan from January to November 2020. A total of 50 pregnant women with preeclampsia as cases (32.20 ± 3.21 years) and 50 normotensive pregnant women as controls (30.68 ± 2.85 years)participated in this study. Three ml of venous blood samples were collected from all participants in K3 EDTA containers. platelets parameters (platelet count and platelet indices) were determined using Mindray BC 3000 Automated Hematology Analyzer. Data were analyzed usingthe SPSS computer program (version 22). Results: The study results showed that the thrombocytopenia account for 56 %, all cases with low PCT (100%). Furthermore, the means of PLTs count, PCT and PDW in cases were (144.40 ± 31.80 × 109/L, 0.13 ± 0.03 % and 15.80 ± 0.45 fl respectively) versus controls (269.40 ± 72.50 × 109/L, 0.22 ± 0.05 % and 15.50 ± 0.29 fl respectively), giving statistically significant differences (P value = 0.000, 0.003 and 0.022 respectively). The mean of PCT of mild cases was lower than severe cases (P value = 0.004); but there were no significant differences in PLTs count, MPV and PDW (P value = 0.379, 0.283 and 0.075 respectively). Conclusion: The study concluded that platelet count (PLTs count) and plateletcrit (PCT) were significantly decreased in pregnant women with preeclampsia especially, so, platelets parameters especially (PLTs count and PCT) should beincluded for assessing and predictingthe risk of severe preeclampsia.


Author(s):  
Sheema Yousuf

Background: Gestational Diabetes Mellitus (GDM) has now become one of the most common and important complication of pregnancy worldwide. There are conflicting results of various studies regarding the role of exercise in reducing the risk of GDM. Therefore, the aim of this study was to determine the effectiveness of exercise on prevention of gestational diabetes. Methods: It is a randomized controlled study directed in the obstetrics and gynecology outpatient clinic of Pakistan Institute of Medical Sciences (PIMS) hospital Islamabad beginning from 6 June 2016 to 5 December 2016 including 170 pregnant women satisfying the inclusion criteria. Group A received routine antenatal care while Group B included the pregnant women that were advised brisk walk for 30 minutes three days per week. At 24-28 week of pregnancy, 75gm oral glucose tolerance test (OGTT) was performed and International association for Diabetes in Pregnancy Study Group (IADPSG) and Hyperglycemia and adverse pregnancy outcome (HAPO) standards, determined GDM. Chi Square was applied for comparing GDM frequency and p value ≤0.05 was considered as significant. Results: The mean age of the patients was 28.08 ± 4.15 years and mean gestation of pregnancy was 17.18 ± 0.78 weeks. Gestational diabetes was seen in 08 (9.41%) patients of non-exercising group while in exercise group only 01 (1.18%) patient had GDM (p-value 0.016). Conclusion: Moderate exercise during pregnancy decreases the risk of gestational diabetes mellitus and is safe for the mother and the baby. However, more studies are needed to establish recommendations.


Author(s):  
Trupti C. Ruge ◽  
Nisha Kanchana

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. 


Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 806
Author(s):  
Przemysław Ustianowski ◽  
Damian Malinowski ◽  
Patrycja Kopytko ◽  
Michał Czerewaty ◽  
Maciej Tarnowski ◽  
...  

Gestational diabetes mellitus (GDM) is carbohydrate intolerance that occurs during pregnancy. This disease may lead to various maternal and neonatal complications; therefore, early diagnosis is very important. Because of the similarity in pathogenesis of type 2 diabetes and GDM, the genetic variants associated with type 2 diabetes are commonly investigated in GDM. The aim of the present study was to examine the associations between the polymorphisms in the ADCY5 (rs11708067, rs2877716), CAPN10 (rs2975760, rs3792267), and JAZF1 (rs864745) genes and GDM as well as to determine the expression of these genes in the placenta. This study included 272 pregnant women with GDM and 348 pregnant women with normal glucose tolerance. The diagnosis of GDM was based on a 75 g oral glucose tolerance test (OGTT) at 24–28 weeks gestation, according to International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. There were no statistically significant differences in the distribution of the ADCY5 gene (rs11708067, rs2877716) and CAPN10 gene (rs2975760, rs3792267) polymorphisms between pregnant women with normal carbohydrate tolerance and pregnant women with GDM. We have shown a lower frequency of JAZF1 gene rs864745 C allele carriers among women with GDM CC + CT vs. TT (OR = 0.60, 95% CI = 0.41–0.87, p = 0.006), and C vs. T (OR = 0.75, 95% CI = 0.60–0.95, p = 0.014). In addition, ADCY5 and JAZF1 gene expression was statistically significantly increased in the placentas of women with GDM compared with that of healthy women. The expression of the CAPN10 gene did not differ significantly between women with and without GDM. Our results indicate increased expression of JAZF1 and ADCY5 genes in the placentas of women with GDM as well as a protective effect of the C allele of the JAZF1 rs864745 gene polymorphism on the development of GDM in pregnant women.


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