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Inadequacy of the risk factor based approach to detect gestational diabetes mellitus

Authors:

NJ Dahanayaka ,

Faculty of Medicine and Allied Sciences, Saliyapura, Anuradhapura, LK
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SB Agampodi,

Faculty of Medicine and Allied Sciences, Saliyapura, Anuradhapura, LK
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ORJC Ranasinghe,

Faculty of Medicine and Allied Sciences, Saliyapura, Anuradhapura, LK
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PMED Jayaweera,

Faculty of Medicine and Allied Sciences, Saliyapura, Anuradhapura, LK
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WAND Wickramasinghe,

Faculty of Medicine and Allied Sciences, Saliyapura, Anuradhapura, LK
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ANCWB Adhikari,

Faculty of Medicine and Allied Sciences, Saliyapura, Anuradhapura, LK
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HKJU Chathurani,

Faculty of Medicine and Allied Sciences, Saliyapura, Anuradhapura, LK
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UT Dissanayaka

Faculty of Medicine and Allied Sciences, Saliyapura, Anuradhapura, LK
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Abstract

Objective To evaluate the present risk factor based approach in diagnosis of gestational diabetes mellitus (GDM) in Sri Lanka in comparison with new guidelines proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG).

Methods A community based cross sectional descriptive study was conducted among pregnant women with gestational age of 24-28 weeks and residing in Anuradhapura district. All eligible pregnant women from selected Medical Officers of Health areas were invited to participate. The 75 g oral glucose tolerance test was carried out among all participants.

Results According to IADPSG criteria, 36 (8.9%) of pregnant women had GDM, compared to 29 (7.2%) according to WHO criteria. Prevalence of GDM in the study population (positive by one or both methods) was 10.6% (n=43) (95% CI 7.9-13.9%). Of these 43 women, 22 (51.1%) had positive results by both methods. Seven (16.3%) and 14 (32.6%) mothers were positive only according to WHO and IADPSG criteria respectively. Out of 29 mothers who fulfilled WHO criteria, only one had an abnormal fasting plasma glucose, but 28 had abnormal 2 hour values. A total of 170 (42.0%) participants had at least one risk factor or early indicator of GDM. A risk based approach would have detected only 22 GDM patients according to IADPSG criteria, missing 14 cases (38.9%) who did not have any of the risk factors for GDM.

Conclusions The risk factor based approach misses more than one third of GDM cases. Urgent revision of current GDM screening guidelines is recommended.

DOI: http://dx.doi.org/10.4038/cmj.v57i1.4193

CMJ 2012; 57(1): 5-9

DOI: https://doi.org/10.4038/cmj.v57i1.4193
How to Cite: Dahanayaka, N., Agampodi, S., Ranasinghe, O., Jayaweera, P., Wickramasinghe, W., Adhikari, A., Chathurani, H. and Dissanayaka, U., 2012. Inadequacy of the risk factor based approach to detect gestational diabetes mellitus. Ceylon Medical Journal, 57(1), pp.5–9. DOI: http://doi.org/10.4038/cmj.v57i1.4193
Published on 25 Mar 2012.
Peer Reviewed

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