Publication:

Evaluation of the incidence and outcome of gestational diabetes mellitus using the current international consensus guidelines for diagnosing hyperglycaemia in pregnancy

Background Diabetes Mellitus in pregnancy has long been recognized as a serious problem for both mother and fetus. Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Even though there are many diagnostic criteria and guidelines for management of GDM, there still exists lack of consensus regarding diagnosis and management of patients with GDM. After Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, International Association of Diabetes in Pregnancy Study Group (IADPSG) has formulated a new consensus guideline for diagnosing hyperglycaemia in pregnancy which has formed the back bone for this particular study. The aim of this study was to assess the incidence of GDM using current international consensus guidelines with 75g Oral Glucose Tolerance Test (OGTT) and evaluation of maternal and fetal outcome.

Methods All antenatal patients were screened for GDM with 75g OGTT and their glycaemic control was evaluated throughout pregnancy. Either Medical Nutritional Therapy or Oral Hypoglycaemic Agents or Insulin Therapy was advised for glycaemic control. Maternal and neonatal outcomes were evaluated.

Results A total of 856 Antenatal patients were screened and 111 were diagnosed as GDM, showing an incidence of 13%. Medical Nutritional Therapy was found to be an effective method for glycaemic control in GDM.

Conclusions The incidence of GDM in the studied population was found to be 13%. Previous history of GDM was found to be the most significant high risk factor associated with GDM followed by family history of Diabetes. Medical Nutritional Therapy was found to be highly effective in the management of GDM. Only 9% of GDM patients required insulin therapy. With adequate glycaemic control, all late pregnancy complications and neonatal complications can be alleviated.