Background: Pregnancy is a diabetogenic state manifested by insulin resistance and hyperglycemia. It is implicated to be associated with significant obstetric complications. India is emerging as capital of diabetes mellitus with ever increasing cases of GDM. Indian women have 11 fold increased risk of developing glucose intolerance during pregnancy compared to Caucasian women. This study is being carried out at Rajah Muthiah Medical College, Chidambaram to find out the merits and demerits of two step approach and DIPSI, to find out the procedure which is simple, reliable, economical and feasible for Indian setting.
Materials and Methods: 200 healthy pregnant women from a rural population attending the antenatal clinic of a teaching hospital at Chidambaram were divided into two groups (100 each). 100 women underwent 50 g OGCT followed by the American Diabetic Association (ADA) recommended 100g OGTT and 100 women underwent DIPSI recommended 75 g OGTT between 24-28 weeks of pregnancy.
Results: Of the 100 women who underwent two step criteria, 12 were diagnosed as GDM. Whereas by DIPSI it was 18. The 2 hr plasma glucose value in the non GDM group was 108±13mg/dl and in the GDM group was 155±13.3 mg/dl (‘p’ value <0.0001).The incidence of drop outs were high with two step approach when compared with DIPSI which is significant. The rates of false positives (about 30%) were also high with two step approach.
Conclusion: Our study has demonstrated that the DIPSI procedure of estimating plasma glucose from single blood sample is simple, reliable, feasible and cost effective. Even if the test is to be repeated in each trimester, the cost of performing DIPSI procedure will be 80% less than the cost of performing two step approach. Further patient compliance is more with DIPSI.
