GESTATIONAL DIABETES; SENSITIVITY, SPECIFICITY AND DIAGNOSTIC ACCURACY OF GLUCOSE CHALLENGE TEST IN DIAGNOSIS

Objective: To find sensitivity specificity and diagnostic accuracy of Glucose Challenge test in diagnosing Gestational Diabetes in Pregnant women. Due to poor socio- economical and educational status, dietary habits and ignorance regarding pregnancy related problems probably increase the prevalence and burden of gestational diabetes mellitus (GDM) and its complications in pregnancy. Best and simple strategy to identify women with gestational diabetes is still lacking and unclear. Study Design: Cross sectional study. Setting and Duration: This study was performed at Jinnah Hospital Lahore, from Nov 2005 to Dec 2006. Methodology: A glucose challenge test (GCT) was performed on 500 selected pregnant women by giving 50-g glucose in water orally. A serum glucose level ≥140 mg/dl after an hour was taken as positive test. To confirm GDM, 75 g glucose in 200 ml of water was given and sugar levels after 2 hrs by Glucometer, >200 mg/dl confirmed GDM. Results: An increasing trend in age, gestational age and BMI and a significant difference regarding positive family history of diabetes and gravidity was seen in patients with GDM compared to normal pregnant. The maximum percentage of GDM 2 was noted in multigravida, between 25-29 years, BMI >28kg/m , and a gestational age of 28 weeks. The sensitivity of GCT was 80%, specificity 97.8%., and diagnostic accuracy was 96.4%. Conclusions: Screening is necessary to identify women with GDM. A 50-g glucose challenge test might be acceptable as a screening test for GDM as it has high sensitivity, specificity and diagnostic accuracy.