Khan Shazia, Bal Himadri, Khan Inam Danish, Paul Debashish
INHS Kalyani Hospital, Clinic of Obstetrics and Gynecology, Visakhapatnam, India.
Dr. DY. Patil Medical College Hospital and Research Centre, Clinic of Obstetrics and Gynecology, Pune, India.
Turk J Obstet Gynecol. 2018 Jun;15(2):75-79. doi: 10.4274/tjod.57255. Epub 2018 Jun 21.
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance that is diagnosed for the first time during pregnancy. This prospective study was undertaken to validate the single-step non-fasting 75 gm Diabetes in Pregnancy Study Group of India (DIPSI) criteria of GDM in Indian patients in comparison with the two-step fasting 100 gm glucose challenge through the Carpenter Coustan criteria (CCC).
Two hundred patients underwent comparative testing using the DIPSI criteria and CCC. Plasma venous blood glucose levels were estimated using the hexokinase method; values ≥140 mg/dL at 2 hours were considered positive according to the DIPSI criteria. Any two values from ≥95 mg/dL for fasting, ≥180 mg/dL at 1 hour, ≥155 mg/dL at 2 hours, and ≥140 mg/dL at 3 hours were considered positive with the CCC.
The mean age and body mass index were 24.26±3.75 years and 20.7±3.07 kg/m2. The sensitivity, specificity, and positive and negative predictive values of the DIPSI guidelines were found as 100%, 97.14%, 83.87%, and 100%, respectively. The positive and negative likelihood ratios were 35.8 and zero. Diagnostic accuracy was found as 97.56%.
DIPSI having high sensitivity, specificity, negative predictive value and diagnostic accuracy. DIPSI offers simplicity, feasibility, convenience, and repeatability while economizing universal screening and diagnosis of GDM on a mass-scale. The DIPSI procedure has the potential to be applied to the entire obstetric population, in the implementation of public health programs to diagnose GDM in the community, thus reaching the needs of the developing world.
妊娠期糖尿病(GDM)被定义为孕期首次诊断出的任何程度的葡萄糖不耐受。本前瞻性研究旨在验证印度妊娠糖尿病研究组(DIPSI)的单步非空腹75克标准在印度患者中诊断GDM的有效性,并与通过卡彭特 - 库斯坦标准(CCC)进行的两步空腹100克葡萄糖耐量试验进行比较。
200名患者使用DIPSI标准和CCC进行了对比检测。采用己糖激酶法测定静脉血浆葡萄糖水平;根据DIPSI标准,2小时时血糖值≥140mg/dL被视为阳性。根据CCC,空腹血糖≥95mg/dL、1小时血糖≥180mg/dL、2小时血糖≥155mg/dL和3小时血糖≥140mg/dL中的任意两项被视为阳性。
平均年龄和体重指数分别为24.26±3.75岁和20.7±3.07kg/m²。发现DIPSI指南的敏感性、特异性、阳性和阴性预测值分别为100%、97.14%、83.87%和100%。阳性和阴性似然比分别为35.8和零。诊断准确性为97.56%。
DIPSI具有高敏感性、特异性、阴性预测值和诊断准确性。DIPSI在大规模节约GDM的通用筛查和诊断的同时,提供了简单性、可行性、便利性和可重复性。DIPSI程序有可能应用于整个产科人群,在社区实施公共卫生项目以诊断GDM,从而满足发展中世界的需求。