Mohan Viswanathan, Mahalakshmi Manni Mohanraj, Bhavadharini Balaji, Maheswari Kumar, Kalaiyarasi Gunasekaran, Anjana Ranjit Mohan, Uma Ram, Usha Sriram, Deepa Mohan, Unnikrishnan Ranjit, Pastakia Sonak D, Malanda Belma, Belton Anne, Kayal Arivudainambi
WHO Collaborating Centre for Non Communicable Diseases Prevention and Control and IDF Centre of Education, Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, 4, Conran Smith Road, Gopalapuram, Chennai, 600 086, India,
Acta Diabetol. 2014 Dec;51(6):1007-13. doi: 10.1007/s00592-014-0660-5. Epub 2014 Oct 15.
The Diabetes in Pregnancy Study Group of India (DIPSI) guidelines recommend the non-fasting 75-g oral glucose tolerance test (OGTT) as a single-step screening and diagnostic test for gestational diabetes mellitus (GDM). The aim of this study was to compare the DIPSI criteria with the World Health Organization (WHO) 1999 and the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria for GDM.
A total of 1,031 pregnant women attending antenatal clinics in urban and rural Tamil Nadu, India, underwent a 75-g OGTT in both non-fasting and fasting states, 2-3 days apart. Venous plasma glucose was measured using an autoanalyser, and GDM was diagnosed by DIPSI, WHO 1999 and IADPSG criteria.
Of the 83 women identified to have GDM by WHO 1999 criteria, only 23 were diagnosed by DIPSI criteria. Of the 106 women diagnosed to have GDM by the IADPSG criteria, only 24 were diagnosed by DIPSI. The DIPSI non-fasting OGTT 2-h VPG cut point of 140 mg/dl (7.8 mmol/l) had a very low sensitivity when compared to the WHO 1999 criteria (sensitivity 27.7 %, specificity 97.7 %) and IADPSG criteria (sensitivity 22.6 %, specificity 97.8 %).
The DIPSI non-fasting OGTT criteria cannot be recommended for diagnosis of GDM due to its low sensitivity. Thus, as a single-step diagnostic test for GDM, the fasting OGTT needs to be done. When this is not possible, the well-established two-step procedure using the 50-g glucose challenge test as an initial screening test, followed by the diagnostic fasting OGTT, can be continued.
印度妊娠糖尿病研究组（DIPSI）指南推荐采用非空腹75克口服葡萄糖耐量试验（OGTT）作为妊娠期糖尿病（GDM）的单步筛查和诊断试验。本研究的目的是比较DIPSI标准与世界卫生组织（WHO）1999年标准以及国际糖尿病与妊娠研究组协会（IADPSG）的GDM标准。
印度泰米尔纳德邦城乡产前诊所的1031名孕妇在非空腹和空腹状态下分别进行了75克OGTT，两次检测间隔2 - 3天。使用自动分析仪测量静脉血浆葡萄糖，并根据DIPSI、WHO 1999年标准和IADPSG标准诊断GDM。
根据WHO 1999年标准确定患有GDM的83名女性中，只有23名通过DIPSI标准诊断。根据IADPSG标准诊断为GDM的106名女性中，只有24名通过DIPSI诊断。与WHO 19
