Title: A Single Glucose Challenge Test procedure for diagnosis of Gestational Diabetes Mellitus
Authors: Dr Kavita Sharma, Dr Vinod Kumar, Dr Shahbaz Khan
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.84
Abstract
Background: In India where prevalence of GDM is 8-17% which is comparatively very high, thus there is need for the screening for glucose intolerance so that we can save both mother as well as child from the adverse future outcomes. With a huge population in the reproductive age in India, a significant segment developing abnormal glucose tolerance is a matter concern.GDM women are thus an ideal group for the primary prevention of diabetes.
Aim: The objective of the study was to compare the efficacy of A Single Glucose Challenge Test with conventional 2hr Oral Glucose Tolerance Test for diagnosing GDM.
Materials and Methods: This is a prospective study for a period of one year from Nov.2010 to Oct.2011performed at Obstetric & Gynaecology deptt. of GMC, Jammu. Out of 460 pregnant women, 334 gave their consent to participate in the study. Out of 334, 200 pregnant women completed the study. Subjects at 16-32 weeks of gestation have been evaluated for presence of GDM by doing single Glucose Challenge Test followed by conventional 2hr Oral Glucose Tolerance Test after 3 days.
Results: The present study very effectively supports that 75gm GCT performed on pregnant women is an easy, economical as well as less cumbersome procedure. Hence, this one step procedure serves as both screening as well as diagnostic procedure in a country with limited resources but requiring universal screening.
Keywords: glucose challenge test, oral glucose tolerance test, gestational diabetes mellitus.
References
- Metzger BE and Coustan DR. Proceedings of the Fourth International Workshop Conference on Gestational Diabetes Mellitus. Diabetes Care 1998;21(Suppl): B1-B167.
- Magee S, Walden CE et al. Influence of diagnogtic criteria on the incidence of gestational diabetes and prenatal morbidity. JAMA1993; 269:609-15.
- Naylor CD, Sermer M et al. Caesarean delivery in relation to birth weight and gestational glucose tolerance: pathophysiology or practice style? JAMA1996; 275:1165-1170.
- Schmidt MI, Duncan BB et al. Gestational diabetes mellitus diagnosed with a 2hr 75gm oral glucose tolerance test and adverse pregnancy outcomes. Diabetes Care2001;24(7):1151-1155.
- O’Sullivan JB and Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes 1964;13: 278-285.
- Pettitt DJ and Knowler WC. Long term effects of the inter-uterine environment, birth weight and breast feeding on Pima Indians. Diabetes Care 1998; 21(Suppl): B138-B141.
- Vohr BR, McGarvey et al. effects of maternal gestational diabetes on offspring adipocity at 4-7 years of age. Diabetes Care1999; 22: 1284-1291.
- Dornhost A, Paterson CM et al. high prevalence of GDM in women from ethnic minority groups. Diabetic Med 1992; 9: 820-822.
- Duncan M. On puerperal diabetes. Trans Obstet Soc Lond 1882; 24: 256-285.
- Miller HC. The effect of diabetic and prediabetic pregnancies on the fetus and new born infant. J Pediatr 1946; 26: 455-461.
- Sacks DA et al. could the fasting plasma glucose may be used to screen for gestational diabetes? J Reprod Med 1992; 37: 902-9.
- Daniel P et al. using fasting plasma glucose concentrations to screen for GDM. A prospective population based study. BMJ 1993; 319:812-5.
- American Diabetes Association Clinical practice recommendations 2002. Diabetes Care 2002; Suppl 1:S1:147.
- De Anguiar LG et al. Could fasting plasma glucose be used for screening high-risk outpatients for gestational diabetes mellitus? Diabetes Care 2001; 24: 954-5.
- Pettitt DJ et al. Comparison of World Health Organisation and National Diabetes Data Group procedures to detect abnormalities of glucose tolerance during oregnancy. Diabetes Care 1994; 17(11): 1264-1268.
- Meltzer SJ, Synder J et al. Gestational diabetes mellitus screening and diagnosis: A prospective randomized controlled trial comparing costs of one-step and two-step methods. BJOG2010; 117(4): 407-15.