Development of an Indian Dietary Risk Score Tool (IDRST) for Early Diagnosis of Gestational Diabetes Mellitus: A Cross Sectional Study

Abstract Aim: This study aims to develop a dietary risk score tool for early identification of gestational diabetes mellitus (GDM). Materials and Methods: A cross-sectional study was carried out in women registered in a tertiary care facility in Hyderabad. Women with a gestational age of ≤12 weeks and without known history of diabetes were included in the study. The structured scoring tool with 13 variables was developed. Women were personally interviewed by the dietitian. The diet and other variables were collected with self-designed questionnaire. Individual score values were assigned to each variable, and the overall score was computed. In the second trimester, these women were followed up with oral glucose tolerance test results and divided into two groups, such as GDM and non-GDM. Appropriate regression methods were carried out to test the association of variables with outcomes. Diagnostic validity was tested using receiver operating characteristic (ROC) curve analysis. Results: There were 530 women in the study, with 174 (32.8%) GDM and 356 (67.2%) non-GDM. The mean age and body mass index (BMI) were found to be 28 years and 26 kg/m 2 in the GDM group and 27 years and 24 kg/m 2 in non-GDM, respectively. Indian dietary factors, such as increased intake of refined carbohydrates, oil, processed/junk foods, and sugary beverages, along with low intake of whole grains, vegetables, and fruits, as well as pre-pregnancy BMI, low physical activity (i.e., walking), history of large for gestational age, and excessive weight gain in pregnancy, have been found to be statistically linked to GDM in univariate analysis. Variables with statistical significance were included in multivariable binary logistic regression. ROC analysis reported an area under a curve of 0.99 at a cutoff score of ≥49.36%. Sensitivity, specificity, and diagnostic accuracy were found to be 94.25%, 97%, and 96.23%, respectively. Conclusions: The developed Indian dietary risk score tool is effective in identifying women at risk of GDM. We recommend the application of this tool in routine care practice to further validate it at various study sites.