Diagnosing GDM: Role of Simple, Cost Effective, and Sensitive DIPSI Test.

The latest criteria on diagnosis and classification of diabetes mellitus [1] were recently published in Diabetes Care. In the section on GDM, the controversy over the one-step/ two-step testing has resurfaced as expected after the NIH consensus statement [2]. One of the reported key factors in NIH decision-making process to favor two-step testing over the one-step IADPSG criteria was that screening with a 50-g glucose challenge test (GCT) does not require fasting and is therefore easier to accomplish for many women. However, it should not be missed that all women who screen positive in 50-g GCT have to undergo a fasting GTT for diagnosis of GDM, and a good number of them test negative, which means undergoing a bothersome testing twice unnecessarily, as well as many of them get missed by a false negative screening. The NIH consensus [2] as well as the present position statement [1] also highlights that there remains a strong consensus that establishing a uniform approach to diagnosing GDM will have extensive benefits for patients, caregivers, and policymakers. In light of these issues, the role of a single-step test for screening and diagnosis of GDM using a 75-g glucose load irrespective of the last meal gains importance. The modified WHO test as proposed by Diabetes in Pregnancy Study Group India (DIPSI), and being used extensively in India, Magon N. (&), Obstetrician, Gynaecologist & Endoscopic Surgeon, Head Department of Obstetrics & Gynecology, Air Force Hospital, Jorhat, India e-mail: [email protected]