COMPARISON OF ORAL GLUCOSE TOLERANCE TEST AND ORAL GLUCOSE CHALLENGE TEST IN GESTATIONAL DIABETES MELLITUS

Dr Naresh Bansal, Dr Monika Aggarwal, Dr A Marwaha, Dr Ks Rajmohan

Abstract


Gestational diabetes mellitus (GDM) is defined by the WHO as carbohydrate intolerance of variable severity that begins or is first recognized during pregnancy, regardless of whether insulin is used for treatment or persists after pregnancy. It does not exclude the possibility of unrecognized glucose intolerance antedating the pregnancy. India has the second highest burden of diabetes in the world.  In India, there are no mandated national screening or diagnostic program for GDM, resulting in a variety of screening, diagnostic and management algorithms used throughout the country. In this study, we compared the Oral Glucose Challenge Test (OGCT) & Oral Glucose Tolerance Test (OGTT) for the diagnosis of Gestational diabetes mellitus. OGCT test is done by administering 50 gms of anhydrous glucose and is considered positive if venous plasma glucose (VPG) concentration after 1 h is >140mg/dL. Women with a positive OGCT underwent 2 h, 75 grams oral glucose tolerance test (OGTT) as a confirmatory test for GDM. When any one of fasting, 1 hr and 2 hr post 75 g OGTT values were >92 mg/dL, >180 mg/dL and >153 mg/dL respectively, women were considered diabetic. We screened 1009 women for GDM by OGCT at 24-28 wks of pregnancy. Total number of women with positive OGCT was 203 (20.11%). Out of these 203 cases, 27 were found to be positive with OGTT. The entire cohort (n=1009) was also subjected to OGTT at 24-28 wks of pregnancy. Of these, same 27 patients (27/1009, 2.7%) were found to be positive for GDM and none of the patients who were OGCT negative were found to be positive with OGTT.  A 50 g OGCT seems to be an effective screening test for diagnosis of GDM which can be used universally in community screening programs and can be done in non fasting state requiring only a single sample.


Keywords


Gestational Diabetes Mellitus (GDM), Oral glucose challenge test (OGCT), Oral glucose Tolerance test (OGTT)

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