Screening for Gestational Diabetes by DIPSI Guidelines

Abstract

Aim and Objectives: The present study was undertaken to find out the role and effectiveness of DIPSI guidelines as a replacement for other more time consuming and cost effective methods for detecting gestational diabetes mellitus ( GDM) in the Indian population and to compare outcome between GDM and non GDM population. Methods: A total of 345 women were selected of low risk category between the gestational ages of 24 to 28 weeks and were subjected to screening for gestational diabetes by DIPSI guidelines. A 75mg oral glucose load was given irrespective of their last Meal timing followed by blood glucose estimation by glucose oxidase – peroxidase method. A report of ≥140mg/dl were labeled as GDM as per DIPSI guidelines. Results: Out of 345 subjects screened, 30 (8.7%) were positive for GDM. The false positives encountered with DIPSI were 0.57% (2/345) and another 2 cases (0.57%) were false negative by DIPSI criteria. The rate of LSCS and rate of macrosomia was significantly higher in GDM population (30% and 33.33% respectively) as   compared to general population (4.4% and 2.5% respectively). In GDM group 23.3% (7) had Shoulder Dystocia compared with 0.6% (2) in the normal population. 10% were breech compared with only 0.2% in the general population with 1 IUFD requiring hysterotomy. The rates of CPD were also higher (3.3%) than the general population (1.5%). A total of 19 neonates required NICU admission of which 11 were IDM. 36.66% of IDM required NICU admission as compared to only 2.5% of the non diabetic population. Conclusions: DIPSI guidelines can use as a replacement for other more resource and time consuming and costly methods like ADA criteria for the detection of GDM in the low resource settings in developing countries.