Gupta Arpit, Daga Prachi
Senior Resident, Department of Nephrology, AIIMS, New Delhi, India.
Senior Resident, Department of Gastroenterology, Medanta, Medicity, India.
J Family Med Prim Care. 2022 Aug;11(8):4545-4548. doi: 10.4103/jfmpc.jfmpc_647_21. Epub 2022 Aug 30.
For many years, there has been a lack of consensus over the appropriate diagnostic criteria for gestational diabetes mellitus (GDM) and the significance of the diagnosis. Multiple guidelines on diagnostic criteria across the world have complicated the diagnosis and further management of the disease, also complicating the healthcare delivery system.
To compare the prevalence of GDM according to Modified Carpenter & Coustan, International association of Diabetes & Pregnancy Group (IADPSG) and DIPSI.
It was cross sectional observational study, conducted at KGMU, Lucknow, Uttar Pradesh between Aug 2016 and Sept 2017. 162 patients were enrolled after fulfilling the inclusion and exclusion criteria.
The study population was derived by screening pregnant females attending for their routine antenatal check up from 24 to 28 weeks of gestation. Plasma glucose levels was measured following 8hrs of overnight fasting. The pregnant females were given 82.5 glucose (equivalent to 75gm anhydrous glucose). Venous blood sample was collected for estimating plasma glucose at 0,1and 2hr.
In our study the prevalence of GDM among study population according to IADPSG criteria was 22.64%, as per Modified Carpenter & Coustan criteria was 17.61% while that as per DIPSI criteria was 13.21%.
Considering IADPSG criteria as gold standard DIPSI is missing 66.6% of patients diagnosed as GDM by IADPSG. Considering Modified C&C criteria as gold standard over the years DIPSI is missing 64.2% of patients diagnosed as GDM by C&C.
多年来,对于妊娠期糖尿病(GDM)的适当诊断标准及其诊断的重要性一直缺乏共识。世界各地关于诊断标准的多个指南使该疾病的诊断和进一步管理变得复杂,也使医疗保健提供系统变得复杂。
根据改良的卡彭特和库斯坦标准、国际糖尿病与妊娠研究组(IADPSG)标准和DIPSI标准比较GDM的患病率。
这是一项横断面观察性研究,于2016年8月至2017年9月在北方邦勒克瑙的KGMU进行。162名患者在满足纳入和排除标准后被纳入研究。
研究人群来自对妊娠24至28周进行常规产前检查的孕妇进行筛查。过夜禁食8小时后测量血浆葡萄糖水平。给孕妇服用82.5克葡萄糖(相当于75克无水葡萄糖)。在0、1和2小时采集静脉血样本以估计血浆葡萄糖。
在我们的研究中,根据IADPSG标准,研究人群中GDM的患病率为22.64%,根据改良的卡彭特和库斯坦标准为17.61%,而根据DIPSI标准为13.21%。
将IADPSG标准视为金标准时,DIPSI遗漏了66.6%被IADPSG诊断为GDM的患者。多年来将改良的C&C标准视为金标准时,DIPSI遗漏了64.2%被C&C诊断为GDM的患者。