Date of Award
5-2019
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Daniel Maina
Second Supervisor/Advisor
Mukaindo Mwaniki
Third Supervisor/Advisor
Erick Njenga
Department
Pathology (East Africa)
Abstract
Background: Worldwide, there is no consensus on the best approach to diagnose gestational diabetes mellitus (GDM) and though oral glucose tolerance testing (OGTT) is considered the gold standard, practices in the administration and interpretation of the test differ depending on the guidelines in use. Previous studies have questioned the utility of glycosuria as a screening test for GDM. Since the studies were conducted, there have been diagnostic threshold changes that might impact its utility.
Justification: Diagnostic cut-offs of OGTT used in GDM diagnosis have evolved over time necessitating re-evaluation of glycosuria. The study was aimed at re-assessing the utility of glycosuria during pregnancy in the local population, where OGTT is not widely available, following adoption of the new diagnostic cut-offs. Objectives To determine the predictive value of any glycosuria as a screening test for GDM diagnosed by International Association of Diabetes Pregnancy Study Groups (IADPSG) and other criteria. To compare the predictive values of glycosuria of varying levels and to determine the association of any glycosuria with risk factors for GDM.
Methods: Retrospective cohort study of consecutively sampled obstetric patients who had OGTT and urine dipstick done from 2013-2018. Positive and negative predictive values, sensitivity and specificity of glycosuria were calculated. Binary logistic regression was done to determine the association of glycosuria with the risk factors for GDM.
Results: Positive and negative predictive values, sensitivity and specificity of any glycosuria were 23.64%, 91.04%, 5.65% and 98.13% respectively when IADPSG criteria were applied. This was better performance than when other criteria were applied and it improved further with increasing severity of glycosuria. Glycosuria was associated with BMI, previous GDM and a family history of diabetes.
Conclusion: Despite the improved predictive value of glycosuria, it is still an unreliable screening test. OGTT should thus be made available to all pregnant women
Recommended Citation
Maranga, J. (2019). The predictive value of urine dipstick glucose test in the Screening for gestational diabetes mellitus in a tertiary private hospital in Kenya (Unpublished master's dissertation). Aga Khan University, East Africa.