Evaluation of the incidence and outcome of gestational diabetes mellitus using the current international consensus guidelines for diagnosing hyperglycaemia in pregnancy
Keywords:GDM, OGTT, NGT, IADPSG, HAPO, Incidence, Glycemic control, Maternal and neonatal outcome
Background: GDM is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. It may be appropriate to screen pregnant women belonging to high-risk populations during the first trimester of pregnancy in order to detect previously undiagnosed Diabetes Mellitus. Formal systematic testing for Gestational Diabetes is usually done between 24 to 28 weeks of gestation. 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 HAPO study, IADPSG has formulated a new consensus guideline for diagnosing hyperglycaemia in pregnancy which has formed the back bone for this particular study.
Methods: This prospective observational study was carried out for a period of one year from July 2014 to Jun 2015 at AFMC, Pune in Dept. of Obstetrics & Gynaecology. To determine if gestational diabetes is present in pregnant women, a standard OGTT was performed with 75 g glucose. The incidence of GDM in antenatal population visiting AFMC, Pune was calculated. Maternal and neonatal outcome was observed and was compared with those of euglycaemic antenatal population.
Results: The incidence of GDM in the antenatal population visiting AFMC, Pune was found to be 12.4%. Family history of Diabetes among first degree relatives is the commonest risk factor associated with GDM. It was found that, with adequate glycaemic control, most of the maternal as well as neonatal complications associated with GDM can be reduced to a level comparable with euglycaemic antenatal population.Conclusions: The new international consensus guideline in diagnosing GDM has shown an incidence of GDM comparable with other criteria for diagnosing GDM. Ensuring an adequate glycaemic control throughout the antenatal period alleviates most of the maternal and neonatal complications associated with GDM.
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