Publication:

To study the clinical profile, management and outcome of diabetic pregnancies in a rural tertiary care institute of Punjab

Background Diabetes mellitus is a disorder of carbohydrate metabolism. In India, about 50.9 million people suffer from diabetes, and this figure is likely to go up to 80 million by 2025, making it the 'diabetes capital' of the world. GDM develops due to an inability to compensate for physiological increase in insulin resistance that develops progressively throughout pregnancy as a consequence of multiple factors including placental hormones, increased caloric intake and reduced physical activity. Many studies report increased incidence of adverse foetal and maternal outcome in diabetic pregnancy.

Methods The present study is a retrospective cum prospective analysis carried out in SGRDIMSAR from 1st May 2015 to 30th April 2017. Patients with diabetic pregnancies who had delivery in our institution were included.

Results Total number of diabetic pregnancies during the study period were 76. Out of 76 patients 15 were PGDM and 61 were GDM. Maximum no of patients in PG group were in age group of 31-35 years, while in GDM group were upto 30 years of age. Gestational age at diagnosis in PGDM group is 13.42±1.2 weeks versus 29.62±4.53 weeks. Maximum patients (70.5%) in GDM group were managed by diet and exercise, while in PGDM group maximum patients (93.3%) needed insulin for glycemic control. Maternal complications were maximum in PGDM group. Most common complication was hypertensive disorders of pregnancy. Mean gestational age at delivery was 35.15±1.42 weeks and 37.06±1.29 weeks in PGDM and GDM respectively (p value= 0.00). 11.8% neonates had a birth weight of >4 kg (macrosomia). 77% of neonates in GDM group had an uneventful outcome.

Conclusions Considering rising incidence and magnitude of the problem and its complications, identification and treatment of diabetic pregnancy is the need of hour.