“COMPARISON OF DIAGNOSTIC ACCURACY OF NON-FASTING DIPSI AND HbA1c WITH FASTING WHO CRITERIA FOR DIAGNOSIS OF GESTATIONAL DIABETES MELLITUS”

Abstract

Objective: 1) To study prevalence of GDM. 2) Diagnostic accuracy of DIPSI and HbA1c in detecting GDM. Methods: 500 pregnant women with singleton pregnancy between 24-32 weeks of gestation were recruited into the study. They underwent DIPSI test and HbA1c in the same sitting. A 2-h 75-gm OGTT was repeated for all women after 72 h in fasting state (WHO criteria). GDM was diagnosed if plasma glucose was ≥140 mg/dl by either test or if HbA1C ≥6%. Results: Of the 500 women, 34 were diagnosed as GDM by WHO criteria, 40 by DIPSI and 28 by HbA1c.Thus, the prevalence of GDM was 6.8% as per WHO criteria, 8% as per DIPSI and 5.6% by HbA1c. The sensitivity of DIPSI test was 94.12%, specicity 98.28%, diagnostic accuracy 97.95%, positive predictive value 80% and negative predictive value 99.57%. The sensitivity of HbA1c with respect to WHO criteria was 52.94%, specicity 97.85%, positive predictive value 64.29%, negative predictive value 96.61%, diagnostic accuracy 95.31%. The area under the ROC curve between DIPSI and WHO criteria was 0.989 while between HbA1c and WHO criteria was 0.923. Conclusion: The DIPSI criteria may be recommended for diagnosing GDM. But, HbA1c does not serve as a good screening test.