ROLE OF ORAL GLUCOSE TOLERANCE TEST IN THE DIAGNOSIS OF GESTATIONAL DIABETES MELLITUS

Abstract

BACKGROUND: Clinical recognition of Gestational Diabetes Mellitus is important because proper recognition and intervention can reduce the well described GDM associated perinatal morbidity and mortality. The frequency of GDM is highly variable and generally reflects the underlying pattern of NIDDM in the particular population. There is no universal agreement on the screening strategies and diagnostic criteria of GDM. Hence, there is a need to identify a single step procedure which serves both as a screening as well as a diagnostic tool for gestational diabetes mellitus. AIMS AND OBJECTIVES: To screen all the antenatal women seeking antenatal care, to detect cases of GDM. To diagnose GDM cases early in pregnancy. MATERIALS AND METHODS: The study was conducted in the Department of General Medicine, Sri Aurobindo Medical College & PG Institute-Indore, between March 2023 and February 2024 on 1595 pregnant women attending the antenatal clinic of the gestational age 16 wks, between 24-26 wks, 32-36 wks and 38 wks irrespective of maternal age and gravidity and presence or absence of clinical or historic risk factors for gestational diabetes mellitus are considered for inclusion in the study. Women who are known cases of Type II diabetes mellitus and those in labour are excluded. RESULTS: In the 1595 women taken for study the incidence of GDM was 4.3%.
INTERPRETATION AND CONCLUSION: In the Indian context with a high prevalence of GDM and where universal screening is mandatory, it is feasible and conducive to opt for the 75g OGTT. The two step procedure of screening with 50g GCT and then diagnosing GDM based on the cutoff values with 100g or 75g is not practical as the pregnant women have to visit the clinic twice and the number of blood samples drawn vary from 3 to 5 which the women resent. Hence for universal screening a single test with 75g of oral glucose and diagnosing women with >140mg% as GDM is recommended.