Publication:

Utility of fasting plasma glucose test as screening tool for gestational diabetes mellitus based on International Association of the Diabetes and Pregnancy Study Group criteria

Background The International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria have recently been endorsed by various bodies for screening and diagnosing Gestational Diabetes (GDM). The present study was done to diagnose gestational diabetes (GDM) by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria in a North Indian Population and to evaluate the performance of fasting plasma glucose (FPG) in screening and diagnosis of GDM.

Methods We conducted a prospective observational study on 417 pregnant women. The women were screened for GDM between 24 weeks and 28 weeks of gestation by 75-g oral glucose tolerance test (OGTT) and GDM diagnosed by the IADPSG criteria.

Results The prevalence of GDM was 17.7% [95% Confidence interval (CI) 21.4 -14.1%] using the IADPSG criteria. Amongst the women diagnosed to have GDM, 64.9% had abnormal fasting plasma glucose (FPG). FPG cut-off value of 92 mg/dL identified 11.5% pregnant women with GDM. FPG cut-off value of 80 mg/dL ruled out GDM in 54.7% women. If 80 mg/dL were made the cut point to decide who should have the 75-g OGTT, then 56.8% (45.3 % with values 5.1 mmol/L) of pregnant women could avoid the 75-g OGTT with the probability that 1.9% of patients with GDM may be missed.

Conclusions FPG at 24-28 weeks’ gestation could be used as a screening test to identify GDM patients. Women with an FPG between ≥ 80 mg/dL and ≤ 92 mg/dL would require a 75-g OGTT to diagnose GDM.