Madhumathi, Y M (2017) A Comparative study of ADA & WHO Criteria for Screening of Gestational Diabetes Mellitus and Follow up of GDM Patients in Salem. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
|
Text
220601017madhumathi.pdf Download (3MB) | Preview |
Abstract
INTRODUCTION : There is no uniform criteria to be followed for screening of GDM. Among controversy exist between different associations in screening for GDM, Screening is essential in all Indian pregnant women as there is a increased risk of developing increased glucose intolerance during pregnancy. There are both maternal and fetal risk due to uncontrolled hyperglycemia during pregnancy. Diabetes in pregnancy increases the risk of obesity and type 2 diabetes mellitus in the offspring as well as the mother in later part of life. Hence glycemic control helps in the prevention of all these complications to the mother and the fetus. IADPSG criteria for diagnosis of GDM had been accepted by most associations including ADA. WHO criteria is different that of IADPSG criteria. Hence the study was conducted to compare the two criteria ADA and WHO for diagnosis of GDM in our population. There is controversy regarding screening for GDM in AN mothers. There is no uniform criteria the world. AIMS AND OBJECTIVES : Our study is to compare the ADA & WHO Criteria for screening of Gestational Diabetes Mellitus. Our objective was to study the implications of implementing the ADA guidelines and WHO guidelines for screening and diagnosis of GDM in Salem. METHODOLOGY : STUDY DESIGN: This is a prospective comparative study. STUDY POPULATION: The study population was selected from ante natal out-patient clinic in the department of obstetrics and gynaecology, GMK Medical College & Hospital. INCLUSION CRITERIA: All ante-natal mothers of gestational age 24 to 28 weeks. EXCLUSION CRITERIA: Pre-existing diabetes. SAMPLE SIZE: 200. STUDY PERIOD: July 2015 to June 2016. Laboratory investigations were performed in the Biochemistry Department, GMKMCH, Salem. METHODOLOGY: All antenatal women attending between 24 and 28 weeks of gestation are subjected to fasting blood glucose measurement followed by an oral glucose tolerance test (OGTT) using 75 g glucose load. Then blood sugar values are collected by venipuncture at the end of 1-h, and 2-h. The ADA and WHO criteria were applied separately for each subject to diagnose GDM. According to the ADA criteria, presence of any one of either fasting-92 mg/dl (5.1 mmol/L), or 1 h-180 mg/dl (10.0 mmol/L) or 2 h-153 mg/dl (8.5 mmol/L) was used for diagnosis of GDM. According to the WHO criteria, any one of either fasting-126 mg/dl (7.0 mmol/L) or 2-h value-140 mg/dl (7.8 mmol/L) was used for diagnosis of GDM. RESULTS: The study was conducted in department of Obstetrics and Gynaecology in government Mohan Kumaramangalam Medical College and Hospital. A total of 200 patients were included in the study. Results are discussed below Clinical characteristics: The average age of patients with GDM at presentation was 25 years. The youngest patient was 19 years and oldest was 40 years. There were nine patients aged 20 years or below, 171 patients in the age group of 20 to 30 and twenty patients were above the age of 30 years. The average gestational age at the time of inclusion in the study was 26.2 weeks. The median gravida of patients with GDM was one. Ninety two patients were primigravida. CONCLUSION: There is no difference among the two recommendations both ADA and WHO in the diagnosis of GDM. • The 2 hour value done has the statistical significance in diagnosis of GDM. • The one hour value done in ADA criteria does not have statistical significance when compared to two hour value. • Risk factor analysis does not have any statistical significance in diagnosis of GDM. • Hence universal screening for GDM is necessary to diagnose GDM.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Comparative study ; ADA & WHO Criteria ; Screening ; Gestational Diabetes Mellitus ; Follow up ; GDM Patients ; Salem. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 18 Dec 2017 12:16 |
| Last Modified: | 18 Dec 2017 12:16 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4404 |
Actions (login required)
 |
View Item |
