Universal versus selective screening for detection of gestational diabetes mellitus in a Malaysian population

  • N Idris
  • Che Hatikah CH
  • Murizah MZ
  • Rushdan MN
Keywords: Gestational diabetes, glucose challenge test, risk-factors, screening, glucose tolerance test

Abstract

Objectives: To compare the efficacy of two screenings methods for gestational diabetes mellitus, namely the universalscreening using 50g Glucose Challenge Test to that of selective screening based on risk factors.

Methodology: A cross-sectional study involving 366 women between 24 weeks to 28 weeks gestation who attended acommunity health clinic for their antenatal care between January to May 2003. All women had their risk factors forgestational diabetes identified at the beginning of the study, after which they underwent a 50g Glucose Challenge Testand subsequently the 75g Oral Glucose Tolerance Test.

Results: The prevalence of gestational diabetes mellitus in this population was 18.3%. The universal screening had asensitivity of 83.5% and specificity of 82.6% compared to that of selective screening, 76.1% and 60.9% respectively.Of all patients diagnosed to have gestational diabetes mellitus, 23.8% were without risk factors.

Conclusion: Universal screening strategy using 50g glucose challenge test is a better predictor of gestational diabetesmellitus compared to risk-based selective screening.

References

Meztger BE, Coustan DR. Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. The Organizing Committee. Diabetes Care. 1998;21(Suppl 2):B161-7.

Report of the Expert Committee on Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997; 20(7):1183-97.

Meztger BE, Buchanan TA, Coustan DR, et al. Summary and recommendations of the Fifth International WorkshopConference on Gestational Diabetes Mellitus. Diabetes Care. 2007;30(Suppl 2):S251-60.

Gestational Diabetes Mellitus. Diabetes Care. 2004;27(Suppl 1):S88-90.

Periodic health examination, 1992 update: 1. Screening for gestational diabetes mellitus. Canadian Task Force on the Periodic Health Examination. CMAJ. 1992;147(4):435-43.

Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148(10):759-65.

Coustan DR, Nelson C, Carpenter MW, et al. Maternal age and screening for gestational diabetes: a population-based study. Obstet Gynecol. 1989;73(4):557-61.

Moses RG, Moses J, Davis WS. Gestational Diabetes: do lean young Caucasian women need to be tested? Diabetes Care. 1998;21(11):1803-6.

Malaysian Diabetes Guideline 2009. Available from: http://www.diabetes.org.my/file_dir/10233255764a4c4d7f8ad0e.pdf.

World Health Organization. Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Report of a WHO Consultation. 1999. Available from: http://whqlibdoc.who.int/hq/1999/WHO_NCD_NCS_99.2.pdf.

Crowther CA, Hiller JE, Moss JR, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Eng J Med. 2005;352(24):2477-86.

Brody SC, Harris R, Lohr K. Screening for gestational diabetes: a summary of the evidence for the U.S. Preventive Services Task Force. Obstet Gynecol. 2003;101(2):380-92.

Cheung NW, Wasmer G, Al-Ali J. Risk factors for gestational diabetes among Asian women. Diabetes Care. 2001;24(5); 955-6.

Boriboonhirunsarn D, Sunsaneevithayakul P, Nuchangrid M. Incidence of gestational diabetes diagnosed before 20 weeks of gestation. J Med Assoc Thai. 2004;87(9):1017-21.

Seshiah V, Balaji V, Balaji MS, et al. Gestational diabetes mellitus in India. J Assoc Physicians India. 2004;52:707-11.

Al Mahroos S, Nagalla DS, Yousif W, et al. A population-based screening for gestational diabetes mellitus in non-diabetic women in Bahrain. Ann Saudi Med. 2005;25(2):129-33.

Tan PC, Ling LP, Omar SZ. Screeninng for gestational diabetes at antenatal booking in a Malaysian university hospital: The role of risk factors and threshold value for the 50g glucose challenge test. Aust N Z J Obstet Gynaecol. 2007;47(3):191-7.

Carr SR. Screening for Gestational Diabetes Mellitus. A perspective in 1998. Diabetes Care. 1998;21(Suppl 2):B14-8.

Published
2009-10-01
How to Cite
IdrisN., CHC. H., MZM., & MNR. (2009). Universal versus selective screening for detection of gestational diabetes mellitus in a Malaysian population. Malaysian Family Physician, 4(2 & 3), 5. Retrieved from https://www.e-mfp.org/ojs3/index.php/MFP/article/view/183
Section
Original Articles