Balaji V, Balaji Madhuri, Anjalakshi C, Cynthia A, Arthi T, Seshiah V
Clinical Epidemiology Division, Dr. V. Seshiah Diabetes Research Institute, Dr. Balaji Diabetes Care Centre, Aminjikarai, Chennai, India.
Indian J Endocrinol Metab. 2011 Jul;15(3):187-90. doi: 10.4103/2230-8210.83403.
To assess the validity of Diabetes in Pregnancy Study Group India (DIPSI) guidelines, a modified version of the WHO criterion to diagnose gestational diabetes mellitus (GDM).
A total of 1 463 consecutive pregnant women in the second and third trimester of pregnancy underwent 75 g oral glucose tolerance test (OGTT) and 2-h plasma glucose (PG) was measured by the glucose oxidase-peroxidase (GOD-POD) method. GDM was diagnosed with 2-h PG ≥ 7.8 mmol/L (WHO criteria) and the rest were classified as normal glucose tolerant (NGT) women. GDM women were advised medical nutrition therapy (MNT) for two weeks. Those who failed to reach the target glycemic level of FPG < 5.0 mmol/L and 2-h PG < 6.67 mmol/L with MNT were advised insulin. All of them were followed throughout pregnancy until delivery. Birth weight of 90th percentile (> 3.45 kg) in the neonates was considered as macrosomia (primary outcome).
The mean maternal age and body mass index were 23.60±3.32 years and 21.5±4.06 kg/m(2) respectively. The mean gestational age was 27.9±5.56 weeks. DIPSI criterion identified 196 women (13.4%) as GDM and the rest as NGT. Insulin was required in 19 (9.7%) women with GDM. Macrosomia was observed in 9.9% GDM women with intervention and 9.8% in NGT (P = 1.000).
DIPSI criterion is a one step-cost effective and evidence-based procedure to diagnose GDM in any socio-economic setting.
评估印度妊娠糖尿病研究组（DIPSI）指南（世界卫生组织诊断妊娠期糖尿病（GDM）标准的修订版）的有效性。
总共1463名妊娠中晚期的连续孕妇接受了75克口服葡萄糖耐量试验（OGTT），并采用葡萄糖氧化酶-过氧化物酶（GOD-POD）法测定2小时血浆葡萄糖（PG）。GDM的诊断标准为2小时PG≥7.8 mmol/L（世界卫生组织标准），其余孕妇被归类为糖耐量正常（NGT）女性。建议GDM女性进行为期两周的医学营养治疗（MNT）。那些通过MNT未能达到空腹血糖（FPG）<5.0 mmol/L和2小时PG<6.67 mmol/L目标血糖水平的孕妇被建议使用胰岛素。所有孕妇在整个孕期直至分娩都接受随访。新生儿出生体重第90百分位数（>3.45 kg）被视为巨大儿（主要结局）。
孕妇的平均年龄和体重指数分别为23.60±3.32岁和21.5±4.06 kg/m²。平均孕周为27.9±5.56周。DIPSI标准将196名女性（13.4%）诊断为GDM，其余为NGT。19名（9.7%）GDM女性需要使用胰岛素。干预组中9.9%的GDM女性出现巨大儿，NGT组为9.8%（P = 1.000）。
DIPSI标准是一种在任何社会经济环境中诊断GDM的一步式、具有成本效益且基于证据的方法。
