scholarly journals Prevalance of Gestational Diabetes Mellitus in Overweight Pregnant Women in Urban Antenatal Clinic at 24-28 Weeks of Gestation

2017 ◽  
Vol 16 (2) ◽  
pp. 55-62
Author(s):  
Rinku Joshi ◽  
Rosy Malla ◽  
Madhur Dev Bhattarai ◽  
Dhan Bahadur Shrestha
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Screening Test ◽  
Challenge Test ◽  
Antenatal Clinic ◽  
Oral Glucose ◽  
Obese Women ◽  
Cross Sectional ◽  
Significant Difference

Introduction: Diabetes has become a significant health problem all over the world and its prevalence is increasing rapidly, including in Nepal. Prevalence of gestational diabetes mellitus (GDM) is directly related to the prevalence of type 2 diabetes. Women who areoverweight or obese before they become pregnant are more at risk of GDM irrespective of other factors.Though the risk of developing GDM in shown to be higher in overweight or obese women, there are very few studies done to show such observation in the urban population of Nepal.Methods: This was a hospital based cross-sectional prospective study conducted among the women attending ante partum clinic, in a tertiary level hospital, located at Lalitpur for one-year duration in 2009. All overweight (pre-pregnancy body mass index (BMI)>23) urban women at 24-28 weeks of gestation were enrolled.Fasting blood glucose, screening 50-g oral glucose challenge test(OGTT) and 2-hr OGTT following overnight fastingwas done as per need based on their test results and GDM was diagnosed based on standard guidelines.Results: Out of 256 women majority of women had BMI >25 kg/m2 (n=180),and 151(59%) were multiparous and 105 (41%) were primiparas. Positive screening test was obtained in 51 women (19.9%).The incidence of GDM by ADA and WHO criteria was 10 (3.9%) and 16 (6.3%) respectively. There was statistically non-significant difference in the rate of positive screening test and BMI (p=0.09). The abnormal screening test between primiparous and multiparous was significant (p=0.01).Conclusion: This study showed a high pre-pregnancy BMI and the incidence of GDMamong the patients enrolled. The rate of positive screening test is also higher than the previous studies so, GDM is a growing issue and must be well addressed.

scholarly journals Prevalence and risk factors associated with gestational diabetes mellitus in urbanised villages of East Delhi

2021 ◽  
Vol 8 (4) ◽  
pp. 1650
Author(s):  
Kalpesh Gohel ◽  
Pragti Chhabra ◽  
S. V. Madhu ◽  
Priyanka Mody ◽  
Shiv Pujari
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Challenge Test ◽  
Study Strategies ◽  
Oral Glucose ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Family History Of Diabetes ◽  
Prevalence Studies

Background: Gestational diabetes mellitus (GDM) is caused by an inability to increase insulin secretion in response to the insulin resistance experienced during pregnancy. This transient hyperglycemia poses immediate health-risks for the baby and long-term in the mother. Thus, GDM offers an experimental opportunity to study strategies for diabetes management.Methods: A cross-sectional study of two urbanized villages in East Delhi was performed over 1.5 years. 290 subjects with >12 weeks gestation, who were residents of the villages for at least 6 months, were enrolled. Detailed demographic and medical history with laboratory findings were collected and glucose challenge test (GCT) and Oral glucose tolerance test (OGTT) were used for screening and diagnosis of GDM.Results: Prevalence of GDM was found to be 9.1% in urbanized villages. High gravida (OR:2.97; 95% CI:1.24-7.12; p<0.014), longer duration of stay at the present residence (OR:2.48; 95% CI:1.05-5.84; p<0.037) and the presence of a family history of diabetes (OR:3.93; 95% CI:1.54-10.02; p<0.04) were found to be significantly associated with the chance of developing GDM in regression analysis. Pregnant women located in urban India for more than three years were 2.48 times more likely to have GDM as compared to those who were residing for lesser duration.Conclusions: As more women reside in urban localities and experience childbearing at a higher age, burden of diabetes mellitus in the community increases. This rising prevalence indicates importance of prevalence studies in a changing Indian geography.

scholarly journals Comparison of Knowledge of Women with Gestational Diabetes Mellitus and Healthy Pregnant Women Attending at Hospital in Bangladesh

2018 ◽  
Vol 16 (1) ◽  
pp. 20-26
Author(s):  
Nowshin Monir ◽  
Zebunnesa Zeba ◽  
Azizur Rahman
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Medical Condition ◽  
Antenatal Clinic ◽  
Health Concern ◽  
Predisposing Factor ◽  
Cross Sectional ◽  
Significant Difference

Background: A very common medical condition during pregnancy is Gestational Diabetes Mellitus (GDM) which has become a global health concern, not only for its higher prevalence, but also because it can be a predisposing factor for type 2 DM and causes other increased health risk for both mother and their offspring in later life.Objective: The objective of the study was to compare knowledge of GDM including source of knowledge, treatment, awareness about GDM and impact of GDM on the baby among mothers with GDM and healthy pregnant mothers.Methodology: The study was a cross-sectional study conducted in Cumilla city from May to October 2016. Eighty-nine participants attending the outpatient department of two hospitals and one antenatal clinic in Cumilla city were selected. A structured questionnaire and in-depth interview method was used to obtain data.Result: Significant difference has been found in knowledge between GDM patients and normal pregnant women regarding source of knowledge (p=0.01), treatment of GDM (p=0.000), risk factors of GDM (p=0.01), problems in managing GDM (p=0.003), nutrition maintenance (p=0.006) and physical exercise (p=0.000). No significant difference has been found in GDM awareness (p=0.83) and its impact on the baby (p=0.28) in two groups. Awareness of GDM is found to be associated with higher education (p=0.000), meal plan (p=0.03) and maintaining nutrition (p=0.01).Conclusion: Knowledge about GDM is poor among pregnant women, especially among normal pregnant women.Journal of Science Foundation 2018;16(1):20-26

scholarly journals Comparison of Venous and Capillary Sampling in Oral Glucose Testing for the Diagnosis of Gestational Diabetes Mellitus: A Diagnostic Accuracy Cross-Sectional Study Using Accu-Chek Inform II

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1011
Author(s):  
Sofia Nevander ◽  
Eva Landberg ◽  
Marie Blomberg ◽  
Bertil Ekman ◽  
Caroline Lilliecreutz
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Oral Glucose ◽  
Sectional Study ◽  
Cross Sectional ◽  
Capillary Sampling

Gestational diabetes mellitus (GDM) is a common complication with negative impacts on mother and child. The primary aim of this study was to examine whether plasma glucose cutoffs for GDM diagnosis based on venous sampling can be replaced by cutoffs based on capillary sampling. A prospective cross-sectional study was performed at an antenatal care clinic including 175 pregnant women undergoing an oral glucose tolerance test (OGTT). Duplicate samples were collected by capillary and venous puncture while fasting and 1 h and 2 h after an OGTT. Both samples were analyzed on Accu-Chek Inform II. The cutoffs for a GDM diagnosis using capillary samples were corrected from 5.1 to 5.3 mmol/L for the fasting sample, from 10.0 to 11.1 mmol/L for the 1 h sample, and from 8.5 to 9.4 mmol/L for the 2-h sample using half of the dataset. Applying these cutoffs to the remaining dataset resulted in a sensitivity, specificity, and accuracy of 85.0%, 95.0%, and 90.3%, respectively, with a positive predictive value (PPV) of 83%, an negative predictive value (NPV) of 96%, and a positive negative likelihood ratio (LHR) of 16.4 using capillary sampling for the GDM diagnosis at fasting and 2-h after. Corrected cutoffs and capillary samples can be used for the diagnosis of GDM with maintained diagnostic accuracy using Accu-Chek Inform II.

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 Factors in Gestational Diabetes Mellitus Predicting the Needs for Insulin Therapy

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Ya Zhang ◽  
Jiashen Shao ◽  
Feifei Li ◽  
Xianming Xu
Keyword(s):  
Diabetes Mellitus ◽  
Multivariate Analysis ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Insulin Therapy ◽  
Nutrition Therapy ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Operating Characteristics ◽  
Significant Difference

Objective.To identify factors predicting the need for insulin therapy in pregnancies complicated by gestational diabetes mellitus (GDM).Methods. A total of 1352 patients with GDM diagnosed by the 75-g/2-h oral glucose tolerance test (OGTT) were enrolled in this study. Univariate and multivariate analysis were performed; receiver operating characteristics (ROC) were also drawn.Results. There was a significant difference in factors such as maternal age, pregestational BMI, first visit SBP, first visit DBP, FBG of first visit, FBG at time of OGTT, 75-g OGTT glucose value (fasting, after 1 h and 2 h), and serum HbA1c level at diagnosis between patients with insulin therapy and patients with medical nutrition therapy (MNT) alone. Multivariate analysis showed that higher FBG at time of OGTT, first 75 g OGTT 2 h plasma glucose, and HbA1c concentration at diagnosis lead to more likely need of insulin therapy.Conclusion. The probability of insulin therapy can be estimated in pregnant women with GDM based on fasting and 2 h glucose values during OGTT and HbA1c value at diagnosis of GDM.

scholarly journals Comparative analysis of current diagnostic criteria for gestational diabetes mellitus

2012 ◽  
Vol 5 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Mariya V Boyadzhieva ◽  
Iliana Atanasova ◽  
Sabina Zacharieva ◽  
Tsvetalina Tankova ◽  
Violeta Dimitrova
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Diagnostic Criteria ◽  
International Association ◽  
Study Groups ◽  
World Health ◽  
Oral Glucose ◽  
Significant Difference ◽  
Iadpsg Criteria

Background To compare current guidelines for diagnosis of gestational diabetes mellitus (GDM) and to identify the ones that are the most relevant for application among pregnant Bulgarian population. Methods A total of 800 pregnant women at high risk for GDM underwent 75 g oral glucose tolerance test between 24 and 28 weeks of gestation as antenatal screening. The results were interpreted and classified according to the guidelines of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), American Diabetes Association (ADA), Australasian Diabetes in Pregnancy Society, Canadian Diabetes Association, European Association for the Study of Diabetes, New Zealand Society for the study of Diabetes and World Health Organization. Results The application of different diagnostic criteria resulted in prevalences of GDM between 10.8% and 31.6%. Using any two sets of criteria, women who were classified differently varied between 0.1% and 21.1% ( P < 0.001).The IADPSG criteria were the most inclusive criteria and resulted in the highest prevalence of GDM. There was a significant difference in the major metabolic parameters between GDM and control groups, regardless of which of the diagnostic criteria applied. GDM diagnosed according to all criteria resulted in increased proportion of delivery by caesarean section (CS). However, only ADA and IADPSG criteria identified both increased macrosomia (odds ratio, 2.36; 2.29) and CS rate. Conclusion The need for GDM screening is indisputable. In our view, the new IADPSG guidelines offer a unique opportunity for a unified national and global approach to GDM.

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

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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