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Cited by 83Gestational Diabetes Research and ManagementDiabetes Management and ResearchDiabetes, Cardiovascular Risks, and Lipoproteins

Screening and diagnosis of gestational diabetes in India: A systematic review and meta-analysis

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Li, Katherine T., Naik, Shilpa, Alexander, Mallika, Mathad, Jyoti S.·2018·Acta Diabetologica
DOI 10.1007/s00592-018-1131-1PMC PMC5999405
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Abstract

Aims Although diabetes is rapidly increasing in India, there is no national consensus on best practices for screening, diagnosis, and management of gestational diabetes mellitus (GDM). The goal of this study was to systematically review the literature for studies reporting the prevalence and screening and diagnostic methods for gestational diabetes in India. Methods We searched MEDLINE, Embase, and POPLINE for studies on screening for GDM in India. We included English-language full reports and conference abstracts of cross-sectional studies, prospective, and retrospective cohorts that reported the screening method and prevalence of GDM. We performed descriptive analysis on all studies and meta-analysis, meta-regression, and subgroup meta-analysis on studies with medium or low risk of bias. Results We included 64 studies reporting 90 prevalence estimates. Prevalence estimates ranged from 0 to 41.9%. Subset meta-analyses showed that the IADPSG diagnostic criteria found significantly more GDM cases (prevalence = 19.19% [15.5, 23.6], p < 0.05) than the WHO 1999 criteria (10.13% [8.17, 12.50]) and DIPSI criteria (7.37% [5.2, 10.16]). Studies that compared the IADPSG and WHO 1999 criteria showed poor positive agreement (33-79%). Studies specifying time of GDM diagnosis showed that patients (11-60%) develop GDM as early as the first trimester, but many GDM cases (16-40%) are missed if screened only at first visit. Conclusions In India, prevalence estimates of GDM vary substantially by diagnostic criteria. When evaluating screening and diagnostic criteria for GDM, providers should consider their patients' needs and correlate screening criteria with pregnancy outcomes.

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  • In India, in 2014 the Government mandated universal GDM screening; at that time pooled GDM prevalence was 8.9%.

    “At that time a pooled GDM prevalence was assessed at 8.9%.”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [220]

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  • In India, 2018 subset meta-analyses showed IADPSG criteria found significantly more GDM cases (19.19%) than WHO 1999 criteria (10.13%), and DIPSI criteria estimated total GDM prevalence at 7.37%.

    “In 2018 subset meta-analyses showed that the IADPSG diagnostic criteria found significantly more GDM cases with a total incidence of 19.19% in comparison to the WHO 1999 criteria at 10.13%. The DIPSI criteria estimated the total prevalence of GDM at 7.37% [220].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [220]

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  1. [2]WHO 2013 Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy WHO Geneva 24199271
  2. [4]Veerasamy S Kapur A Balaji V Divakar H 2015 A perspective on testing for gestational diabetes mellitus Indian J Endocrinol Metab 19 4 529 532 26180771 PMC4481662
  3. [5]Gupta Y Kalra B 2016 Screening and diagnosis of gestational diabetes mellitus JPMA 66 9 Suppl 1 S19 S21 27582144
  4. [6]Mohan V Usha S Uma R 2015 Screening for gestational diabetes in India: where do we stand? J Postgrad Med 61 3 151 154 26119432 PMC4943414
  5. [7]Rani PR Begum J 2016 Screening and diagnosis of gestational diabetes mellitus, where do we stand J Clin Diagn Res 10 4 QE01 QE04 PMC4866200 27190902
  6. [8]Seshiah V 2010 Diabetes in pregnancy study G. Fifth national conference of diabetes in pregnancy study group, India J Assoc Physicians India 58 329 330 21117358
  7. [9]Mahalakshmi MM Bhavadharini B Maheswari K 2016 Current practices in the diagnosis and management of gestational diabetes mellitus in India (WINGS-5) Indian J Endocrinol Metab 20 3 364 368 27186555 PMC4855966
  8. [10]Babu GR Tejaswi B Kalavathi M 2015 Assessment of screening practices for gestational hyperglycaemia in public health facilities: a descriptive study in bangalore. India J Pub Health Res 4 1 448 25918698 PMC4407043
  9. [11]Seshiah V Balaji V Balaji MS Sanjeevi CB Green A 2004 Gestational diabetes mellitus in India J Assoc Physicians India 52 707 711 15839447
  10. [12]Vanlalhruaii RS Prasad L Singh NN Singh TP 2013 Prevalence of gestational diabetes mellitus and its correlation with blood pressure in Manipuri women Indian J Endocrinol Metab 17 6 957 961 24381867 PMC3872711
  11. [13]Gopalakrishnan V Singh R Pradeep Y 2015 Evaluation of the prevalence of gestational diabetes mellitus in North Indians using the International Association of Diabetes and Pregnancy Study groups (IADPSG) criteria J Postgrad Med 61 3 155 158 26119433 PMC4943402
  12. [14]Hoy D Brooks P Woolf A 2012 Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement J Clin Epidemiol 65 9 934 939 22742910
  13. [15]Macaulay S Dunger DB Norris SA 2014 Gestational diabetes mellitus in Africa: a systematic review PLoS ONE 9 6 e97871 24892280 PMC4043667
  14. [16]Anjana RM Deepa M Pradeepa R 2017 Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study Lancet Diabetes Endocrinol 5 8 585 596 28601585
  15. [17]Balaji V Madhuri BS Paneerselvam A Arthi T Seshiah V 2012 Comparison of venous plasma glucose and capillary whole blood glucose in the diagnosis of gestational diabetes mellitus: a community-based study Diabetes Technol Ther 14 2 131 134 21992269
  16. [18]Bhavadharini B Mahalakshmi MM Anjana RM 2016 Prevalence of Gestational Diabetes Mellitus in urban and rural Tamil Nadu using IADPSG and WHO 1999 criteria (WINGS 6) Clin Diabetes Endocrinol 2 1 8 28702243 PMC5471800
  17. [20]Hill JC Krishnaveni GV Annamma I Leary SD Fall CH 2005 Glucose tolerance in pregnancy in South India: relationships to neonatal anthropometry Acta Obstet Gynecol Scand 84 2 159 165 15683377
  18. [21]Jain R Davey S Davey A Raghav SK Singh JV 2016 Can the management of blood sugar levels in gestational diabetes mellitus cases be an indicator of maternal and fetal outcomes? The results of a prospective cohort study from India J Family Commun Med 23 2 94 99 PMC4859105 27186155
  19. [22]Kulkarni SR Fall CH Joshi NV 2007 Determinants of incident hyperglycemia 6 years after delivery in young rural Indian mothers: the Pune Maternal Nutrition Study (PMNS) Diabetes Care 30 10 2542 2547 17620450 PMC2405891
  20. [23]Madhavan A Beena Kumari R Sanal MG 2008 A pilot study on the usefulness of body mass index and waist hip ratio as a predictive tool for gestational diabetes in Asian Indians Gynecol Endocrinol 24 12 701 707 19172540
  21. [24]Mathai M Thomas TJ Kuruvila S Jairaj P 1994 Random plasma glucose and the glucose challenge test in pregnancy Natl Med J India 7 4 160 162 7950945
  22. [25]Nayak PK Mitra S Sahoo JP Daniel M Mathew A Padma A 2013 Feto-maternal outcomes in women with and without gestational diabetes mellitus according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria Diabetes Metab Syndr 7 4 206 209 24290085
  23. [26]Neelakandan R Sethu PS 2014 Early universal screening for gestational diabetes mellitus J Clin Diagn Res 8 4 OC12 OC14 24959483 PMC4064925
  24. [27]Rajput R Yogesh Y Rajput M Nanda S 2012 Utility of HbA1c for diagnosis of gestational diabetes mellitus Diabetes Res Clin Pract 98 1 104 107 22456454
  25. [28]Ramachandran A Snehalatha C Shyamala P Vijay V Viswanathan M 1994 Prevalence of diabetes in pregnant women—a study from Southern India Diabetes Res Clin Pract 25 1 71 74 7835214
  26. [29]Ramachandran A Snehalatha C Clementina M Sasikala R Vijay V 1998 Foetal outcome in gestational diabetes in south Indians Diabetes Res Clin Pract 41 3 185 189 9829347
  27. [30]Seshiah V Balaji V Balaji MS 2008 Prevalence of gestational diabetes mellitus in South India (Tamil Nadu)—a community based study J Assoc Physicians India 56 MAY 329 333 18700640
  28. [31]Seshiah V Balaji V Shah SN 2012 Diagnosis of gestational diabetes mellitus in the community J Assoc Physicians India 60 15 17 23405515
  29. [32]Seshiah V Balaji V Balaji MS 2007 Gestational diabetes mellitus manifests in all trimesters of pregnancy Diabetes Res Clin Pract 77 3 482 484 17292506
  30. [33]Soumya S Rohilla M Chopra S 2015 HbA1c: a useful screening test for gestational diabetes mellitus Diabetes Technol Ther 17 12 899 904 26496534
  31. [34]Tripathi R Tolia N Gupta VK Mala YM Ramji S Tyagi S 2012 Screening for gestational diabetes mellitus: a prospective study in a tertiary care institution of North India J Obstet Gynaecol Res 38 2 351 357 22176476
  32. [36]Anjalakshi C Balaji V Balaji MS Seshiah V 2007 A prospective study comparing insulin and glibenclamide in gestational diabetes mellitus in Asian Indian women Diabetes Res Clin Pract 76 3 474 475 17113179
  33. [37]Anjalakshi C Balaji V Balaji MS Ashalata S Suganthi S Arthi T 2009 A single test procedure to diagnose gestational diabetes mellitus Acta Diabetol 46 1 51 54 18830559
  34. [38]Arora GP Thaman RG Prasad RB 2015 Prevalence and risk factors of gestational diabetes in Punjab, North India: results from a population screening program Eur J Endocrinol 173 2 257 267 26012589
  35. [40]Ghosh S Ghosh K 2013 Maternal and neonatal outcomes in gestational diabetes mellitus J Indian Med Assoc 111 5 330 1, 336 24765693
  36. [41]Grewal E Kansara S Kachhawa G 2012 Prediction of gestational diabetes mellitus at 24 to 28 weeks of gestation by using first-trimester insulin sensitivity indices in Asian Indian subjects Metabolism 61 5 715 720 22146095
  37. [42]Kalra P Kachhwaha CP Singh HV 2013 Prevalence of gestational diabetes mellitus and its outcome in western Rajasthan Indian J Endocrinol Metab 17 4 677 680 23961485 PMC3743369
  38. [43]Mohan MA Chandrakumar A 2016 Evaluation of prevalence and risk factors of gestational diabetes in a tertiary care hospital in Kerala Diabetes Metab Syndr 10 2 68 71 26476488
  39. [44]Mohan V Mahalakshmi MM Bhavadharini B 2014 Comparison of screening for gestational diabetes mellitus by oral glucose tolerance tests done in the non-fasting (random) and fasting states Acta Diabetol 51 6 1007 1013 25315629 PMC4239809
  40. [46]Nilofer AR Raju VS Dakshayini BR Zaki SA 2012 Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes Indian J Endocrinol Metab 16 Suppl 1 S74 S78 22701851 PMC3354928
  41. [49]Sagili H Kamalanathan S Sahoo J 2015 Comparison of different criteria for diagnosis of gestational diabetes mellitus Indian J Endocrinol Metab 19 6 824 828 26693435 PMC4673813
  42. [50]Sahariah SA Potdar RD Gandhi M 2016 A daily snack containing leafy green vegetables, fruit, and milk before and during pregnancy prevents gestational diabetes in a randomized, controlled trial in Mumbai, India J Nutr 146 7 1453S 1460S 27281802 PMC4926846
  43. [51]Satodiya M Takkar N Goel P Kaur J 2016 Comparison of one-step versus two-step screening for diagnosis of GDM in Indian population: a randomized controlled trial J Obstet Gynecol India 67 3 1 6 PMC5425642 28546666
  44. [52]Sharma K Wahi P Gupta A 2013 Single glucose challenge test procedure for diagnosis of gestational diabetes mellitus: a Jammu cohort study J Assoc Physicians India 61 8 558 559 24818340
  45. [53]Somani B Arora M Bhatia K Arora D Banerjee M 2012 A comparative study of the different diagnostic criteria of gestational diabetes mellitus and its incidence Med J Armed Forces India 68 1 6 11 24623912 PMC3862958
  46. [54]Surapaneni T Nikhat I Nirmalan PK 2013 Diagnostic effectiveness of 75 g oral glucose tolerance test for gestational diabetes in India based on the International Association of the Diabetes and Pregnancy Study Groups guidelines Obstet Med 6 3 125 128 27708704 PMC5032920
  47. [55]Uma R Bhavadharini B Ranjani H 2017 Pregnancy outcome of gestational diabetes mellitus using a structured model of care: WINGS project (WINGS-10) J Obstet Gynaecol Res 43 3 468 475 28026897
  48. [56]Veeraswamy S Divakar H Gupte S Datta M Kapur A Vijayam B 2016 Need for testing glucose tolerance in the early weeks of pregnancy Indian J Endocrinol Metab 20 1 43 46 26904467 PMC4743382
  49. [57]Verma A Singh B Mengi V 2008 Gestational diabetes in rural women of jammu Indian J Commun Med 33 1 54 55 PMC2782232 19967000
  50. [58]Wahi P Dogra V Jandial K Bhagat R 2011 Prevalence of gestational diabetes mellitus (GDM) and its outcomes in Jammu region J Assoc Physicians India 59 227 230 21755759
  51. [59]Balaji V Balaji M Anjalakshi C Cynthia A Arthi T Seshiah V 2011 Diagnosis of gestational diabetes mellitus in Asian-Indian women Indian J Endocrinol Metab 15 3 187 190 21897895 PMC3156538
  52. [61]Bhatt AA Dhore PB Purandare VB Sayyad MG Mandal MK Unnikrishnan AG 2015 Gestational diabetes mellitus in rural population of Western India—results of a community survey Indian J Endocrinol Metab 19 4 507 510 26180767 PMC4481658
  53. [62]Bhattacharya SM 2002 Glucose screening test results in first and early third trimester of pregnancy: is there any correlation? J Obstet Gynaecol Res 28 6 304 307 12512927
  54. [63]Bhattacharya SM 2004 Fasting or two-hour postprandial plasma glucose levels in early months of pregnancy as screening tools for gestational diabetes mellitus developing in later months of pregnancy J Obstet Gynaecol Res 30 4 333 336 15238113
  55. [65]Jali MV Desai BR Gowda S Kambar S Jali SM 2011 A hospital based study of prevalence of gestational diabetes mellitus in an urban population of India Eur Rev Med Pharmacol Sci 15 11 1306 1310 22195364
  56. [66]Kragelund Nielsen K Damm P Kapur A 2016 Risk factors for hyperglycaemia in pregnancy in Tamil Nadu, India PLoS ONE 11 3 e0151311 26991305 PMC4798719
  57. [67]Mahalakshmi MM Bhavadharini B Maheswari K 2016 Comparison of maternal and fetal outcomes among Asian Indian pregnant women with or without gestational diabetes mellitus: a situational analysis study (WINGS-3) Indian J Endocrinol Metab 20 4 491 496 27366715 PMC4911838
  58. [68]Maheshwari JR Mataliya MV 1989 A random plasma glucose method for screening for gestational diabetes J Postgrad Med 35 1 36 39 2585336
  59. [69]Malhotra S Hazarika PC Dhall K 1988 A screening programme for gestational diabetes Indian J Med Res 87 252 256 3397159
  60. [72]Rajput M Bairwa M Rajput R 2014 Prevalence of gestational diabetes mellitus in rural Haryana: a community-based study Indian J Endocrinol Metab 18 3 350 354 24944930 PMC4056134
  61. [73]Sahu L Satyakala R Rani R 2009 Comparison of the American Diabetes Association and World Health Organization criteria for gestational diabetes mellitus and the outcomes of pregnancy Obstet Med 2 4 149 153 27579060 PMC4989660
  62. [75]Swami SR Mehetre R Shivane V Bandgar TR Menon PS Shah NS 2008 Prevalence of carbohydrate intolerance of varying degrees in pregnant females in Western India (Maharashtra)—a hospital-based study J Indian Med Assoc 106 11 712 714 19368095
  63. [76]Zargar AH Sheikh MI Bashir MI Masoodi SR 2004 Prevalence of gestational diabetes mellitus in Kashmiri women from the Indian subcontinent Diabetes Res Clin Pract 66 2 139 145 15533581
  64. [77]Nayak PK Mitra S Sahoo J Kamalnathan S 2014 Comparison of the world health organization and the international association of diabetes and pregnancy study groups criteria in diagnosing gestational diabetes mellitus in South Indians Indian J Endocrinol Metab 18 3 433 434 24944950 PMC4056154
  65. [78]Swami SR Mehetre R Shivane V Bandgar TR Menon PS Shah NS 2008 Prevalence of carbohydrate intolerance of varying degrees in pregnant females in western India (Maharashtra)—a hospital-based study J Indian Med Assoc 106 11 712 714 19368095
  66. [81]Wu ET Nien FJ Kuo CH 2016 Diagnosis of more gestational diabetes lead to better pregnancy outcomes: comparing the international association of the diabetes and pregnancy study group criteria, and the carpenter and coustan criteria J Diabetes Investig 7 121 126 PMC4718104 26816609
  67. [82]Duran A Sáenz S Torrejón MJ Bordiú E Valle L Galindo M 2014 Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St.Carlos Gestational Diabetes Study Diabetes Care 37 9 2442 2450 24947793
  68. [83]Mostafa SA Davies MJ Webb DR Srinivasan BT Gray LJ Khunti K 2012 Independent effect of ethnicity on glycemia in South Asians and White Europeans Diabetes Care 35 8 1746 1748 22699291 PMC3402276
  69. [84]Shang M Lin L 2014 IADPSG criteria for diagnosing gestational diabetes mellitus and predicting adverse pregnancy outcomes J Perinatol 34 2 100 104 24232664
  70. [85]Jenum AK Morkrid K Sletner L 2012 Impact of ethnicity on gestational diabetes identified with the WHO and the modified International Association of Diabetes and Pregnancy Study Groups criteria: a population-based cohort study Erratum appears in Eur J Endocrinol. 2012 Mar; 166(3):561 Note: Vange, Siri [corrected to Vangen, Siri] Eur 166 2 317 324 PMC3260695 22108914
  71. [86]Seshlah V Sahay BK Das AK 2009 Gestational diabetes mellitus—Indian guidelines J Indian Med Assoc 107 11 799 806 20469784
  72. [88]Basu A Sarkar-Roy N Majumder PP 2016 Genomic reconstruction of the history of extant populations of India reveals five distinct ancestral components and a complex structure Proc Natl Acad Sci 113 6 1594 1599 26811443 PMC4760789
  73. [89]Shetty PS 2002 Nutrition transition in India Pub Health Nutr 5 1a 175 182 12027282
  74. [90]Yadav K Krishnan A 2008 Changing patterns of diet, physical activity and obesity among urban, rural and slum populations in north India Obes Rev 9 5 400 408 18627500
  75. [91]Daniel CR Prabhakaran D Kapur K 2011 A cross-sectional investigation of regional patterns of diet and cardio-metabolic risk in India Nutr J 10 12 21276235 PMC3042918
  76. [92]Savitz DA Janevic TM Engel SM Kaufman JS Herring AH 2008 Ethnicity and gestational diabetes in New York City, 1995–2003 BJOG Int J Obstet Gynaecol 115 8 969 978 18651880
  77. [93]Beischer NA Oats JN Henry OA Sheedy MT Walstab JE 1991 Incidence and severity of gestational diabetes mellitus according to country of birth in women living in Australia Diabetes 40 Suppl 2 35 38 1748263
  78. [94]Chu SY Abe K Hall LR Kim SY Njoroge T Qin C 2009 Gestational diabetes mellitus: all Asians are not alike Prev Med 49 2–3 265 268 19596364
  79. [97]IADPSG Consensus Panel 2010 International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy Diabetes Care 33 3 676 682 20190296 PMC2827530
  80. [98]National Diabetes Data Group 1979 Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance Diabetes 28 1039 1057 510803
  81. [99]O'Sullivan JB Mahan CM 1964 Criteria for the oral glucose tolerance test in pregnancy Diabetes 13 278 285 14166677

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Authors
Li, K. T., Naik, S., Alexander, M., & Mathad, J. S.
Affiliations
  • Cornell University (US)
  • Johns Hopkins University (US)
  • Weill Cornell Medicine (US)
Corresponding author
Li, Katherine T.
ORCID
Venue
Acta Diabetologica
Publisher
Springer Science and Business Media LLC
Published
2018-03-26
Volume
55
Issue
6
Pages
613-625
ISSN
  • 0940-5429 (ISSN-L)
  • 1432-5233
DOI
10.1007/s00592-018-1131-1
PMC
PMC5999405
OpenAlex
W2791703084
Cited by
83
References
6
Citations by year
2026: 6 · 2025: 8 · 2024: 9 · 2023: 14 · 2022: 17 · 2021: 14 · 2020: 8 · 2019: 7
FWCI
1.18
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Acta Diabetologica (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Weill Cornell Medical College
  • National Institute of Allergy and Infectious Diseases (K23AI129854)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
gestational diabetes mellitus, GDM screening, GDM diagnosis, diagnostic criteria, IADPSG criteria, DIPSI criteria, GDM prevalence, India, first trimester, missed diagnosis
MeSH terms
Adult, Female, Glucose Tolerance Test, Humans, India, Mass Screening, Pregnancy, Pregnancy Outcome, Prenatal Diagnosis, Prevalence, Diabetes, Gestational

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