Document Detail


Screening for gestational diabetes mellitus: the Sri Lankan experience.
MedLine Citation:
PMID:  17180809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate tests used for screening and confirmation of gestational diabetes mellitus (GDM) in Sri Lanka.
METHODS FIELD BASED: Consecutive pregnant women in Homagama DDHS area (n = 853), were assessed for risk factors and subjected to random and postprandial urinary Benedict's and Dipstick tests, fasting and 2 hour post 75 g glucose capillary blood glucose (FBG and 2hBG) which were validated against 75 g oral glucose tolerance test (OGTT) performed at 24-28 weeks (WHO criteria).
HOSPITAL BASED: Retrospective analysis of consecutive high-risk women (n = 999) and prospective study of randomly selected GDM women (n = 66) to assess predictive value of the OGTT.
RESULTS FIELD BASED: Sensitivity and specificity respectively of random urine Benedict's, 10%, 99.2%; postprandial urine Benedict's, 52.2%, 94.5%; postprandial urine Dipstick, 68.7%, 90%; capillary FBG threshold 4.1 mmol/l, 62.6%, 73%; capillary 2hBG threshold 7.2 mmol/l, 98.5%, 95.2%; risk factors, 93.1%, 22.2%.
HOSPITAL BASED: OGTT-11.6% lag curves, 16.3% abnormal, FPG accuracy at 4.7mmol/l; predictive value of 2 hPG > or = 8.9 mmol/l for insulin treatment-sensitivity 97.2%, specificity 71.4%.
CONCLUSIONS: Current practice of random urine testing in community screening for gestational diabetes is unreliable, and glucose specific postprandial urine test improves sensitivity. FPG is unsuitable for screening, the 2 hour post 75 g blood glucose at a threshold of > 7.2 mmol/l is sensitive and specific. In laboratory confirmation using 75 g OGTT the fasting plasma glucose has low predictive value, 2 hour test performed alone is liable to false positives and 2 hour glucose > 8.9 mmol/l following a peak at 1 hour suggests the need for insulin treatment.
Authors:
C N Wijeyaratne; S Ginige; A Arasalingam; C Egodage; K Wijewardhena
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Ceylon medical journal     Volume:  51     ISSN:  0009-0875     ISO Abbreviation:  Ceylon Med J     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-12-21     Completed Date:  2007-02-22     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  1264702     Medline TA:  Ceylon Med J     Country:  Sri Lanka    
Other Details:
Languages:  eng     Pagination:  53-8     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo, Sri Lanka. mandika59@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose / analysis
Diabetes, Gestational / blood,  diagnosis*,  prevention & control
Female
Glucose Intolerance
Glucose Tolerance Test
Humans
Mass Screening / methods*
Predictive Value of Tests
Pregnancy
Prospective Studies
Retrospective Studies
Risk Assessment
Risk Factors
Sri Lanka
Chemical
Reg. No./Substance:
0/Blood Glucose
Comments/Corrections
Comment In:
Ceylon Med J. 2007 Jun;52(2):72; author reply 73   [PMID:  17691568 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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