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Gestational diabetes mellitus

Jan 05, 2016

Gestational diabetes mellitus (GDM) is on the rise globally and is expected to rise further due to obesity, inactivity, unhealthy eating and older age of pregnant mothers. Many women are entering their pregnancy unaware of their glucose tolerance.

Consequences to the mother in the short and long term and the fetus and newborn are many. Treatment of GDM has resulted in better outcomes in terms of baby weight, operative deliveries, birth trauma and lowered perinatal morbidity. Also screening for GDM identifies women who are at risk for future diabetes. The ideal method for screening and diagnosis is still debated though there is a trend towards a consensus. The HAPO study and the subsequent recommendations from IADPSG have given for the first time an outcome based recommendations. Feasibility of adopting these recommendations in resource limited settings is a concern for some countries. Management of GDM has also been debated with the conflicts between insulin vs oral hypoglycemic agents, emerging evidence on the safety concerns with Glyburide and lack of long term effects of the oral agents on the baby. The followup after pregnancy has been particularly disappointing.

What are the screening and diagnostic methods that you use and the challenges or limitations with those ?

Information about the moderators

Dr Usha Sriram is director of ACEERhealth, an organization involved in providing clinical services to people with diabetes and endocrine disorder based in Chennai, India. She is also the director of Women2women.

Dr Belma Malanda is a MD and the project manager of IDF Policy and Programmes Department. He coordinates the Women and Diabetes Programme with an initial focus on a project aimed at improving care for women with gestational diabetes (WINGS) in India.


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