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Universal Screening for Gestational Diabetes Mellitus ( GDM ) : Mandatory
| Content Provider | Semantic Scholar |
|---|---|
| Author | N. Purandare C. |
| Copyright Year | 2012 |
| Abstract | India today is being recognized as the diabetic capital of the world. Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first diagnosed during pregnancy [1]. It is a serious medical complication of pregnancy, which affects 1.1–14.3 % of pregnant women depending on the ethnic and clinical characteristics of the population and the diagnostic test employed [2]. The increasing incidence of GDM is because of, apart from other risk factors, rise in maternal age and maternal body mass index. Prevalence rates are found to be higher in black Hispanic, native American and Asian women compared to white women. In India, 79 million people are expected to have diabetes mellitus by the year 2030 (1). The prevalence of GDM in India varies from 9.9 % in rural population to 17.8 % in urban areas (2) [3]. The National Family Health Survey (NFHS) III—2005–2006 of India reported an increasing prevalence, 14.8 %, of overweight women aged 15–49 years (ranging from 28.9 % in urban areas to 8.6 % in rural areas) compared to 10.6 % in 1998–99 (3). [4] GDM has adverse outcomes of pregnancy including preeclampsia, caesarean section rates (which varied from 30 to 40 %), perinatal mortality (2-fold increased), birth defects, macrosomia (3-fold increased), shoulder dystocia, metabolic complications in neonates and morbidity associated with subsequent childhood obesity. Furthermore, the recurrence risk with future pregnancies has been reported as high as 68 % [4], and 26 % [5] risk of developing type two diabetes at 15 years of follow up. Therefore, the diagnosis of GDM offers a unique opportunity in identifying individuals who will be benefited by early therapeutic intervention with diet and exercise, thus normalizing the weight to delay or even possibly prevent the onset of diabetes. In 2005, Crowther et al. [6] reported in their randomized controlled trial that treatment of GDM reduced serious perinatal morbidity (combined endpoint of death, shoulder dystocia, bone fracture and nerve palsy) and the incidence of large-for-gestational-age infants. In 2009, Landon et al. [7] reported that treatment of women with mild GDM showed significant reduction in large-forgestational-age infants, shoulder dystocia, caesarean section, preeclampsia or gestational hypertension and less maternal weight gain. Therefore, due to its high incidence, major impact on pregnancy outcome and therapeutic approaches, a universal, instead of a selective, screening has been recommended. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://jogi.co.in/march_april_2012/01_editorial_universal_screening.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
