High proportion of overt diabetes mellitus in pregnancy and missed opportunity for early detection of diabetes at a tertiary care centre in Pakistan

  • Aisha Syed Wali
  • Raheela Rafique
  • Sundus Iftikhar
  • Rakhshinda Ambreen
  • Mohammad Yawar Yakoob
Keywords: Diabetes mellitus in pregnancy, Gestational diabetes, Overt diabetes in pregnancy, Pre-gestational diabetes

Abstract

Objectives: To determine the frequency of diabetes in pregnancy (DIP), namely pre-gestational, gestational (GDM) and overt diabetes mellitus (DM) in women registered for delivery.

Methods: A retrospective chart review of antenatal women registered between January 01 to August 31, 2017 was performed. Gestational age, diagnosis of DIP, glucose levels at diagnosis and other relevant data was extracted. The effect of various fasting blood glucose (FBG) thresholds for diagnosis of DIP was assessed.

Results: DIP was diagnosed in 21.8% women (pre-gestational: 2%, GDM: 81.2%, overt DM: 16.8%). In early registrants, 30.2% were detected through screening. However, 55.3% of women registered late. Women with pre-gestational DM were older, had more miscarriages, and greater personal and family history of diabetes versus GDM and overt DM. Raising the diagnostic threshold of FBG from 92 mg/dl to 95 mg/dl missed three women (0.1%) and to 105 mg/dl, missed six women (0.2%).

Conclusion: We observed a high proportion of overt DM. In early registrants, almost one third of DIP was diagnosed in the first half of pregnancy, an opportunity missed in late registrants. Altering diagnostic thresholds of DIP affected only a small proportion of women.

doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1723

How to cite this:
Wali AS, Rafique R, Iftikhar S, Ambreen R, Yakoob MY. High proportion of overt diabetes mellitus in pregnancy and missed opportunity for early detection of diabetes at a tertiary care centre in Pakistan. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S38-S43. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1723

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2019-11-28