PMID- 28639597
OWN - NLM
STAT- MEDLINE
DCOM- 20180321
LR  - 20220409
IS  - 0971-5916 (Print)
IS  - 0971-5916 (Linking)
VI  - 145
IP  - 2
DP  - 2017 Feb
TI  - Evaluation of 75 g glucose load in non-fasting state [Diabetes in Pregnancy Study 
      group of India (DIPSI) criteria] as a diagnostic test for gestational diabetes 
      mellitus.
PG  - 209-214
LID - 10.4103/ijmr.IJMR_1716_15 [doi]
AB  - BACKGROUND & OBJECTIVES: There is no consensus regarding optimal standard for 
      diagnosis of gestational diabetes mellitus (GDM). In this study, use of 75 g 
      glucose load in non-fasting state [Diabetes in Pregnancy Study Group of India 
      (DIPSI) criteria] as a diagnostic test for GDM in pregnant women was compared 
      with different oral glucose tolerance tests (OGTTs). METHODS: This prospective 
      study included 936 pregnant women, who underwent plasma glucose evaluation two 
      hours after the challenge of 75 g glucose load irrespective of the timing of last 
      meal (DIPSI criteria for GDM). After three days, standard 75 g OGTT was done in 
      all women irrespective of previous plasma glucose value. Accuracy of the first 
      result was compared to OGTT using cut-offs as per the World Health Organization 
      (WHO) and International Association of Diabetes and Pregnancy Study Groups 
      (IADPSG) criteria for the diagnosis of GDM. RESULTS: Of the total 936 pregnant 
      women, 73 (7.8%) patients had plasma glucose value >/=140 mg/dl when measured two 
      hours after glucose load. When comparing with the WHO and IADPSG criteria, the 
      sensitivity values were 65.1 and 74.1 per cent, respectively, and the 
      corresponding specificity values were 96.3 and 96.9 per cent, respectively. On 
      comparing with the WHO OGTT, only 41 of the 73 (56.2%) were true positives, 
      whereas when IADPSG criteria were used, true positives were 46 (63%). False 
      negative cases were also present when classified by the WHO and IADPSG criteria 
      though in lesser numbers than false positives. The positive predictive values 
      (PPVs) for the WHO and IADPSG criteria were 56.1 and 63 per cent, respectively, 
      and their corresponding negative predictive values were 97.7 and 97.9 per cent, 
      respectively. INTERPRETATION & CONCLUSIONS: Our findings showed that when 75 g 
      glucose load in non-fasting state was used as a diagnostic test for GDM, almost 
      one quarter of patients with GDM escaped diagnosis as sensitivity values were 
      low. On the other hand, some GDM cases were falsely labelled as normal as this 
      test did not account for cases of fasting hyperglycaemia. In addition, comparison 
      with other OGTTs showed low PPVs. Hence, use of DIPSI criteria for diagnosing GDM 
      must be reconsidered till further validation.
FAU - Tripathi, Reva
AU  - Tripathi R
AD  - Department of Obstetrics & Gynaecology, Lok Nayak Hospital, New Delhi, India.
FAU - Verma, Divya
AU  - Verma D
AD  - Department of Obstetrics & Gynaecology, Lok Nayak Hospital, New Delhi, India.
FAU - Gupta, Vinod Kumar
AU  - Gupta VK
AD  - Department of Biochemistry, G.B. Pant Hospital, New Delhi, India.
FAU - Tyagi, Shakun
AU  - Tyagi S
AD  - Department of Obstetrics & Gynaecology, Lok Nayak Hospital, New Delhi, India.
FAU - Kalaivani, M
AU  - Kalaivani M
AD  - Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Ramji, Siddarth
AU  - Ramji S
AD  - Department of Neonatology, Lok Nayak Hospital, New Delhi, India.
FAU - Mala, Y M
AU  - Mala YM
AD  - Department of Obstetrics & Gynaecology, Lok Nayak Hospital, New Delhi, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Indian J Med Res
JT  - The Indian journal of medical research
JID - 0374701
RN  - 0 (Blood Glucose)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Adult
MH  - Blood Glucose
MH  - Diabetes, Gestational/*diagnosis/*metabolism/pathology
MH  - Female
MH  - Glucose/*administration & dosage
MH  - Glucose Tolerance Test/*methods
MH  - Humans
MH  - Pregnancy
PMC - PMC5501053
COIS- Conflicts of Interest: None.
EDAT- 2017/06/24 06:00
MHDA- 2018/03/22 06:00
PMCR- 2017/02/01
CRDT- 2017/06/23 06:00
PHST- 2017/06/23 06:00 [entrez]
PHST- 2017/06/24 06:00 [pubmed]
PHST- 2018/03/22 06:00 [medline]
PHST- 2017/02/01 00:00 [pmc-release]
AID - IndianJMedRes_2017_145_2_209_208361 [pii]
AID - IJMR-145-209 [pii]
AID - 10.4103/ijmr.IJMR_1716_15 [doi]
PST - ppublish
SO  - Indian J Med Res. 2017 Feb;145(2):209-214. doi: 10.4103/ijmr.IJMR_1716_15.