Publication:

A study of glycemic control with diet in women with gestational diabetes mellitus

Background Gestational diabetes (GDM) represents carbohydrate intolerance first discovered in pregnancy, occurs in 3.8-21% of pregnancies. Postpartum glucose intolerance returns to normal in majority. However, there is high risk of developing impaired glucose tolerance or overt diabetes mellitus later in life. Balanced diet at proper time can help achieving glycemic control. It also helps women with GDM to avoid need for insulin reducing costs of treatment.

Methods Study was done in Dhiraj Hospital in Obstetrics and Gynecology department. Study duration was 1.5 years. It was a prospective study comprising of patients who came with raised blood glucose levels on their 1st visit.

Results Prevalence of GDM (2.87%) is observed to be comparable to various other centres. Highest number of GDM cases was observed in age group of 26-30 years (62.96%). Control of glycemia with diet could be achieved in majority of women (53.85%) at 3 months post-partum as reflected by FBS levels. Incidence of Macrosomia (29.63%) and LSCS (77.78%) could not be lessened by glycemic control with diet in women with GDM.

Conclusions Prevalence of GDM was comparable to that of other studies. Rate of caesarean section was very high and main indications being foetal distress and cephalopelvic disproportion. Maternal and perinatal morbidity increases as duration of GDM increases. Control of glycemia with dietary treatment can help reduce occurrence of complications in mother and baby. It requires proper compliance, absence of which calls for need of insulin in most of patients with uncontrolled glycemia since first.