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. 2017 Oct;67(5):337-342.
doi: 10.1007/s13224-017-0962-y. Epub 2017 Feb 20.

Comparison of Diagnostic Accuracy of Non-fasting DIPSI and HbA1c with Fasting WHO Criteria for Diagnosis of Gestational Diabetes Mellitus

Pikee Saxena  1 , Puja Verma  1 , Binita Goswami  2
Affiliations

Comparison of Diagnostic Accuracy of Non-fasting DIPSI and HbA1c with Fasting WHO Criteria for Diagnosis of Gestational Diabetes Mellitus

Pikee Saxena et al. J Obstet Gynaecol India. 2017 Oct.

Abstract

Background: To compare diagnostic accuracy of non-fasting DIPSI and HbA1c with fasting WHO 1999 as gold standard for diagnosis of gestational diabetes mellitus (GDM).

Methods: Pregnant women attending antenatal clinic underwent a 2-h 75-gm GCT in non-fasting state (DIPSI). HbA1c was also determined at the same sitting. A 2-h 75-gm GCT was repeated for all women after 72 h in a fasting state (WHO criteria). GDM was diagnosed if plasma glucose was ≥140 mg/dl by either test or if HbA1C ≥6%.

Results: Of the 800 women evaluated, 51 were diagnosed as GDM by WHO criteria, 63 by DIPSI, and 40 by HbA1c. The sensitivity of DIPSI test with respect to WHO 1999 was 98.04% and specificity 98.26%. The diagnostic accuracy was 98.25%. The area under the ROC curve for DIPSI was 0.988 (p < 0.001) (95% confidence interval: 0.960-1.000). The sensitivity of HbA1c with respect to WHO GTT was 47.06%, specificity 97.86%, and diagnostic accuracy 94.63%. The ROC curve between WHO GTT and HbA1c covered an area of 0.805 (p < 0.01) (95% confidence interval: 0.731-0.879).

Conclusions: Non-fasting DIPSI criteria had high diagnostic accuracy compared to gold-standard WHO GTT and can be an effective and practical alternative to the latter. HbA1c had a low sensitivity although the specificity was good and therefore is not a suitable test for screening GDM.

Keywords: DIPSI; GDM; HbA1C; WHO GTT.

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Conflict of interest statement

Conflict of interest

Authors have no conflict of interest in the findings of this study.

Ethical Statement

This study was initiated after approval from the Ethics Committee of Human Research of the Institute. Enrollment and conduct of the study were done in accordance with ICH-GCP guidelines.

Human and Animal Rights

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Patient flowchart
Fig. 2
Fig. 2
Risk factors for GDM groups
See this image and copyright information in PMC

References

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