Prashant Arun Uikey1 , Sayalee Vivek Pathak2 , Megha Pandurang Tajne3 , Saurabh Chandrakant Sankalecha4
BACKGROUND Incidence of Gestational Diabetes Mellitus (GDM) in India is 10 - 14.3%. GDM is known to have adverse foetomaternal outcome. These complications are preventable with early diagnosis and appropriate management. There is a need for a simple, cost-effective screening test for timely diagnosis of GDM. This study aims at comparing the efficacy of O’Sullivan’s method and Diabetes in Pregnancy Study Group India (DIPSI) test in predicting the foetomaternal outcome. METHODS This is a prospective observational study conducted over a period of 18 months at a tertiary care centre in central India. 900 antenatal patients between 24 - 28 weeks of gestation were divided into two groups of 450 each. One group was subjected to O’Sullivan’s method and other to DIPSI test. The socio-demographics, risk factors, and foetomaternal outcome in the two groups were compared. RESULTS The incidence of GDM in DIPSI group was 15.1% and that in O’Sullivan’s group was 9.5%. The incidence was higher in patients who were more than 30 years of age, and in second gravida. 81.08% patients belonged to class 5 of the socioeconomic strata. 90.9% patients with GDM had a BMI of more than 25. 46.84% patients of GDM had positive family history of Diabetes Mellitus. 70.2% diabetic patients had term deliveries. Rates of LSCS in DIPSI group was 52.9% and that in O’Sullivan’s group was 72.09%. Incidence of foetal macrosomia in diabetic mothers was 11.66%. 15.3% neonates of diabetic mothers required NICU admissions. Majority of the babies were admitted with neonatal hyperbilirubinemia, neonatal hypoglycaemia, and birth asphyxia. Including both the groups, 66.73% patients required insulin for control of blood sugar levels, and 33.27% patients were managed with proper diet and / or oral hypoglycaemics. CONCLUSIONS DIPSI has been found to have comparable efficacy to the two-step gold standard O’Sullivan’s method in predicting the foetomaternal outcome. DIPSI being a onestep procedure, easy to perform, cost effective, procedure with better patient compliance can be advocated as the procedure of choice for screening and diagnosis of GDM in low resource setting like that in India.
