Universal screening of gestational diabetes mellitus in antenatal women with 50 grams glucose challenge test

Abstract

Introduction: Indians belong to high-risk group, universal screening policy is applicable to Indian population. There is a two way approach for screening - one step and two-step. The two-step approach is cumbersome and inconvenient for the patients. Aims: To study the prevalence of gestational diabetes mellitus using 50gm 1 hour oral glucose challenge test (OGCT). To assess the need for universal screening and to compare the occurrence of GDM in normal antenatal cases with those patients who have risk factors for GDM. Material and Methods: This was a prospective study done over a period of one and half years. The study included 600 pregnant women of 24-32weeks gestation who underwent the 1 hour OGCT with 50 gm glucose followed by 75gms OGTT in positive individuals. Results: The mean age of study population was 22.99 years. Parity wise, 52.33 % were primigravida. The mean age of GDM patients was 26.1 Years. 19.6 of study population had risk factors for GDM. Past history of fetal loss beyond 20 weeks of gestation, age above 25yrs, family history of type 2 DM were the three most common risk factors being present in 17%, 1.66% and 1.66% cases. Positivity was more common in patients with risk factors for GDM compared to those without risk factors. Overall prevalence of GDM by the two step approach was 7% in our study population. Among 42 GDM patients 31 patients had one or more risk factors. Family history of diabetes (14.28%) and previous history of fetal loss (14.28%) were the two most prevalent risk factors. Only 35.7 % of GDM patients were >25yrs. Conclusions: For universal screening, we suggest 50gms OGCT which has 100% sensitivity, and 98.75 % specificity as observed in our study. This procedure is easily acceptable, economical, and feasible in the Indian context