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Acta Diabetologica

, Volume 55, Issue 6, pp 613–625 | Cite as

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

  • Katherine T. Li
  • Shilpa Naik
  • Mallika Alexander
  • Jyoti S. Mathad
Original Article
  • 199 Downloads

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.

Keywords

Gestational diabetes Pregnancy India Screening 

Notes

Acknowledgements

We would like to thank Weill Cornell Medicine librarians Kevin J. Pain and Becky B. Nelson for their assistance with searching the literature; Elizabeth Mauer for her assistance in conducting meta-analysis; and Dr. Amita Gupta for her input on writing.

Author’s contributions

JSM and KL motivated and conceived of the study. KL and SN searched for literature and analyzed results. KL, MA, and JSM interpreted the results. KL wrote the article. MA and JSM critically reviewed the article. All authors reviewed and edited the article.

Compliance with ethical standards

Conflict of interest

All the author declares that they have no conflict of interest.

Ethics approval

As this was a review study, no ethics approval was required.

Informed consent

As this was a review study, no informed consent was required.

Consent for publication

All authors provided consent for publication.

Supplementary material

592_2018_1131_MOESM1_ESM.docx (323 kb)
Supplementary material 1 (DOCX 323 kb)

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Katherine T. Li
    • 1
  • Shilpa Naik
    • 2
  • Mallika Alexander
    • 3
  • Jyoti S. Mathad
    • 4
  1. 1.Weill Cornell Medical CollegeNew YorkUSA
  2. 2.Department of OB-GYNByramjee Jeejeebhoy Government Medical CollegePuneIndia
  3. 3.Johns Hopkins University Clinical Trials UnitByramjee Jeejeebhoy Government Medical CollegePuneIndia
  4. 4.Departments of Medicine and OB-GYNWeill Cornell MedicineNew YorkUSA

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