With the National Gestational Diabetes Mellitus (GDM) Day being observed on March 10, doctors, while acknowledging that awareness on GDM had made a marked improvement over the years, pinpointed the need for early screening.
V. Seshiah, former professor of diabetology, Madras Medical College and founder-patron of Diabetes in Pregnancy Study Group India, said awareness of GDM was definitely better now as obstetricians and gynaecologists were concerned about it.
“My concept is that we should screen all pregnant women. We recommend screening in the first trimester, around six to seven weeks of pregnancy. If we diagnose GDM in the first trimester, we can take care of both mother and child,” he said.
He added that GDM puts the woman at risk for developing diabetes in the future. “Within 10 years, 50% of them can develop diabetes. Children born to them can develop diabetes and obesity. In my experience, in 90% of women who develop GDM, the levels can be controlled with medical and nutritional therapy,” he added.
Usha Sriram, head of Endocrinology and Diabetes, Voluntary Health Services, said when it came to GDM, care before, during and after the pregnancy was important.
“The fact is that we now screen for GDM early in pregnancy. Women could have abnormal glucose early in pregnancy. It is slowly becoming a standard of care and women are being screened at the first antenatal check-up. Women planning pregnancy or those who are pregnant should be aware of GDM. This is where a lot of work is to be done, especially among young people,” she said.
In the present time, pre-diabetes, over weight, family history of diabetes, polycystic ovarian syndrome and sedentary lifestyle could put women at the risk of GDM. “This is why checking for blood sugar levels is recommended,” Dr. Sriram said. She added that once diagnosed with GDM, women should stay healthy and within the recommended weight gain range during pregnancy. “After the pregnancy is over, follow-up is vital. Breastfeeding has shown to decrease the risk for diabetes,” she said. Prevention is key, she said, adding that all young women, who plan for pregnancy in six months to one year, should be healthy, take folic acid and be active.
Anand Moses, former director, Institute of Diabetology, Madras Medical College, said the prevalence of GDM was on the rise. “It varies from 10% to 15% among pregnant women. This is why we recommend universal screening for pregnant women, as in many cases, GDM can be managed with diet control. They need to split meals and avoid simple sugars,” he said.
Follow-up post delivery was lacking, he said, adding: “Lifestyle management is very important and so are annual check-ups after delivery.
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