Pravinraj S, Tajudeen Mohamed M, Zala Darshana, Senthil Rajini, Jafrin Mercy M
Department of Community Medicine, Sri Lakshmi Narayanan Institute of Medical Science, BIHER, Puducherry, India.
J Family Med Prim Care. 2024 Nov;13(11):5296-5300. doi: 10.4103/jfmpc.jfmpc_894_24. Epub 2024 Nov 18.
Gestational diabetes mellitus (GDM) is a major concern in recent years. During pregnancy, it is difficult to consume 75 g of glucose in the fasting state as pregnant women may experience symptoms such as vomiting. The Diabetes in Pregnancy Study Group India (DIPSI) criterion requires a single prick in the non-fasting state to collect the sample for diagnosing GDM.
This study aimed to assess the diagnostic accuracy of DIPSI criteria compared to the WHO criteria for GDM diagnosis.
A community-based cross-sectional study was conducted among pregnant mothers attending the primary health centers in Puducherry from August 2022 to November 2022.
A total of 384 samples were selected, and 75 g of anhydrous glucose was given after 8 hours of overnight fasting. Both fasting and postprandial venous blood sugar levels were measured to determine the prevalence of GDM as per the WHO 2013 criteria. After 2 days, GDM was diagnosed among all study participants based on the DIPSI criteria. Further analysis was done.
The prevalence of GDM was 14.1% and 12.8% per the WHO 2013 and DIPSI criteria, respectively. In comparison to the WHO 2013 criteria, DIPSI had 79.63% sensitivity, 98.18% specificity, 87.76% positive predictive value, and 96.72% negative predictive value. The results of kappa statistics showed that there was almost perfect agreement between the WHO 2013 criteria and DIPSI criteria.
The present study shows that the DIPSI criteria can be used to screen and diagnose GDM as there is no need for overnight fasting. The blood glucose value can be measured easily with a single prick, which is comfortable for both pregnant women and treating doctors.
妊娠期糖尿病(GDM)是近年来的一个主要关注点。在孕期,由于孕妇可能会出现呕吐等症状,很难在空腹状态下摄入75克葡萄糖。印度妊娠糖尿病研究组(DIPSI)标准要求在非空腹状态下单次采血来采集样本以诊断GDM。
本研究旨在评估DIPSI标准与世界卫生组织(WHO)诊断GDM标准相比的诊断准确性。
2022年8月至2022年11月,在本地治里初级卫生中心就诊的孕妇中开展了一项基于社区的横断面研究。
共选取384份样本,过夜禁食8小时后给予75克无水葡萄糖。测量空腹和餐后静脉血糖水平,根据WHO 2013标准确定GDM患病率。2天后,根据DIPSI标准对所有研究参与者进行GDM诊断。并进行了进一步分析。
根据WHO 2013标准和DIPSI标准,GDM患病率分别为14.1%和12.8%。与WHO 2013标准相比,DIPSI的灵敏度为79.63%,特异度为98.18%,阳性预测值为87.76%,阴性预测值为96.72%。kappa统计结果显示,WHO 2013标准与DIPSI标准之间几乎完全一致。
本研究表明,DIPSI标准可用于筛查和诊断GDM,因为无需过夜禁食。通过单次采血就能轻松测量血糖值,这对孕妇和主治医生来说都很方便。