International Journal of Clinical Biochemistry and Research


Comparison of American Diabetes Association (ADA) and World Health Organization (WHO) criteria in the screening and diagnosis of gestational diabetes mellitus in South Indian population


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Article Type : Research Article

Author Details: Arul Vijaya Vani,Suganya Soundravally,Haritha Sagili*,Niranjjan

Volume : 6

Issue : 2

Online ISSN : 2394-6377

Print ISSN : 2394-6369

Article First Page : 234

Article End Page : 238


Abstract

Introduction: Diagnosis of gestational diabetes mellitus (GDM) depends on the guidelines used.This study was carried out to compare ADA criteria`s diagnostic accuracy and validity in diagnosing GDM and its complication considering WHO criteria as gold standard. 
Materials and Methods: Patients who underwent 75 gram Oral Glucose Tolerance test (OGTT) for GDM screening were included in the study. The retrospective data included 559 subjects, whereas prospective design included 620 mothers who were followed for maternal and foetal outcomes. 
Results: Prevalence of GDM was 11.2%. ADA and WHO criteria were found to have an agreement of 0.69. Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value of ADA was 69.81%, 97.58%, 74.0% and 97.03% respectively. WHO second hour identified all cases of GDM. Mothers diagnosed to have GDM by either criterion were older, had increased body mass index. The difference in the prevalence of preeclampsia (p=0.02), macrosomia (p=0.001) and increased birth weight (p=0.003) were found to be significant in WHO criteria alone. Maternal and foetal outcomes didn’t show any significant difference.
Conclusion: This study concludes that the diagnostic accuracy of ADA was comparable with WHO criteria. WHO criteria predicated the complications of GDM at a higher rate than ADA criteria. WHO second-hour criterion alone may be used as a screening test to diagnose GDM.

Keywords: American diabetes association, Foetal outcomes, Gestational diabetes mellitus, Maternal outcomes, World health organization.

Doi :-https://doi.org/10.18231/j.ijcbr.2019.052