BLOOD GLUCOSE CONTROL DURING PREGNANCY IN GESTATIONAL DIABETES MELLITUS RESULTS IN A LOWER RISK OF PREGNANCY INDUCED HYPERTENSION (PIH) & BETTER MATERNAL-FETAL OUTCOMES

Abstract

Objective: In Gestational Diabetes Mellitus GDM, pregnancy-induced hypertension PIH and low birth weight of newborns <2.5 kg are major and significant causes of maternal and fetal morbidity & mortality in developing worlds with low resource settings. Can we reduce these risks by Controlling Blood sugar and resulting in better maternal-fetal outcomes? Design and method: A prospective cohort study was done for one year from October 1, 2013, to September 31, 2014, at 198 diabetic screening units as a part of the Project approved by the Indian Government in Kanpur, state of Uttar Pradesh district. 57,108 pregnant women were screened during their 24–28th weeks of pregnancy by impaired oral glucose test OGTT Single Test Procedure with 2 Hour Post Blood glucose 140 mg/dl after 75 gm of Glucose load irrespective of non-fasting approved by, Govt of India. Maternal and perinatal outcomes were followed up in GDM who have controlled Blood glucose value postprandial 2 hours of <140 mg/dl and those with uncontrolled GDM Group with >140 mg/dl between 2013 and 2014 in public health facilities with low resource settings. Results: Out of the Total number of Gestational Diabetes Mellitus cases followed up in this study, 5043; out of them, 4589 GDM women's blood Glucose was mild to moderately controlled < 140 mg/dl throughout pregnancy by Medical Nutrition therapy MNT & Insulin use and 454 GDM blood Glucose were not the well-controlled groups for not following MNT strictly and low insulin use 1.1% Pregnancy-induced hypertension PIH and low birth weight of newborns <2.5 kg are major significant causes of maternal and fetal morbidity & mortality in developing worlds with scarce resource settings. We found that Pregnancy Induced Hypertension in GDM cases with <140 mg/dl Control was 2.98% compared to 9.3% in Blood glucose >140 mg/dl GDM women; low birth weight was 15.6% in an uncontrolled group compared to 8.9% in the control group. Conclusions: Blood Glucose control, in public health facilities, may result in better outcomes, specially pregnancy-induced hypertension, and low birth weight risk, which contribute significantly to morbidity and mortality of mothers and infants with GDM