A comparitive study in diagnosis and management of gestational diabetes mellitus with oral glucose challenge test and HbA1C
Indian Journal of Obstetrics and Gynecology Research
Diabetes mellitus in pregnancy is one of the major complications during pregnancy. Pregnancies with gestational diabetes mellitus are associated with distinct spectrum of adverse maternal and perinatal outcomes such as birth injury, fetal growth abnormalities, increased rates of Caesarean section, and long-term risk for both the mother and baby. Numerous screening procedures and diagnostic guidelines have been used based on the suitability of test to the individual and population
... , cost of test and screening accuracy. Still debate exists on the most suitable test for screening of GDM as different diagnostic criterias followed in different countries. Hence Universal screening tool for GDM is necessary, which is economical, suitable and feasible especially in Indians, who are at higher risk of developing GDM. Current evidence suggests mainly two tests; Oral glucose challenge test (OGCT) and glycosylated hemoglobin (HbA1C) for diagnostication and prognostication of GDM. Of this, OGCT, WHO recommended, is a simple and cost-effective screening tool. Materials and Methods: It is a prospective study conducted at Adichunchanagiri Institute of Medical Sciences, B.G.Nagar, Mandya. 100 cases were selected randomly at 24-28 gestational weeks and all 100 cases underwent OGTT, OGCT and HbA1C. In OGCT > 140mg/dl and in HbA1C >5% taken as positive. Conclusion: According to available evidence, overall diagnostic efficiency of OGCT is superior to HbA1C and fructosamine throughout a broad range of clinical settings. OGCT is a patient friendly test, as it is performed regardless of the timing of last meal, causing minimum interference in the routine activities of the mother. An early diagnosis of diabetes and strict glucose control are crucial for preventing or delaying the onset of serious, life-threatening complications. Although OGCT, HbA1C remains the standard for diagnosing diabetes and glycemic monitoring emerging evidence attests that additional biomarkers such as fructosamine.