COMPARISION OF DIAGNOSTIC ACCURACY OF NON – FASTING DIPSI AND HBAIC WITH FASTING WHO CRITERIA FOR DIAGNOSIS OF GESTATIONAL DIABETES MELLITUS

Abstract

Background Gestational Diabetes Mellitus [GDM] is dened as Carbohydrate intolerance with recognition or onset during pregnancy and resolves postpartum. Prevalence of GDM in India varies from 3.8 - 21% with different demography and diagnostic methods used. As early diagnosis and control of maternal hyperglycaemia plays a vital role in prevention of adverse outcomes, universal screening is almost mandatory due to high prevalence, we need a simple economical, feasible test with higher sensitivity to diagnose GDM. Aim To compare diagnostic accuracy of two nonfasting tests DIPSI & HBAIC and fasting WHO criteria for diagnosis of GDM. Objectives To compare DIPSI with WHO criteria as standard. To compare HBA1C with WHO criteria as standard Results: This study was done on 100 ANC cases to compare diagnostic accuracy of DIPSI & HBAIC with fasting World Health Organization Glucose Tolerance Test. Mean age of participants was 27.18±4.60 years. 39% patients were in age group of 21 to 25 years and 34% patients were in age group of 26 to 30 years. Majority (45%) of the patients were in gestational age of 26 to 30 weeks. In this study, gestational diabetes mellitus was diagnosed in 47 (47%) patients according to WHO GTT, in 48 (48%) patients according to DIPSI and in 34 (34%) patients according to Glycated Haemoglobin. Mean gestational age of patients during diagnosis of gestational diabetes mellitus was 29.21±2.84 weeks by DIPSI, 28.83±2.82 weeks by WHO GTT and 29.29±3.15 weeks by Glycated Haemoglobin. Mean blood sugar parameters of gestational diabetes mellitus women were 174.96±16.58 mg/dl by DIPSI, 173.21±17.58 mg/dl by WHO GTT and 9.41±1.91 gm% by Glycated Haemoglobin. The sensitivity of DIPSI with regard to WHO GTT was 89.36%, specicity 88.68%, positive predictive value 87.50%, negative predictive value 90.38%, diagnostic accuracy 89.00% and chi square value of 60.78. These values convey that DIPSI is as good as gold standard WHO GTT criteria. The sensitivity of Glycated Haemoglobin with regard to WHO GTT was 51.06%, specicity 81.13%, positive predictive value 70.59%, negative predictive value 65.15%, diagnostic accuracy 67.00% and chi square value of 11.51. These values convey that Glycated Haemoglobin is not as good as gold standard WHO GTT. Conclusions: Based on ndings from this study it can be concluded that DIPSI is equally as good as World Health Organization Glucose Tolerance Test criteria in diagnosing gestational diabetes mellitus in antenatal women of south India. Since DIPSI does not require fasting it is more feasible than World Health Organization criteria. Glycated haemoglobin estimation is another test to detect diabetes mellitus which does not require fasting however its results are not close to gold standard WHO criteria unlike DIPSI.