Abstract
Background: Globally, Gestational Diabetes Mellitus(GDM) affects almost 7% of all pregnancies. In India, GDM prevalence ranges from 6 to 9% in rural and 12 to 21% in urban area, but there is limited evidence from the north eastern states of Assam. Screening of GDM is not routine practice due to challenging topography of Assam. Our study makes an effort to determine the extent of GDM in low resource settings of Assam through Mobile Medical Units(MMUs), which have access to remote villages. Methods: This was a community based cross-sectional study, where pregnant women in the gestational age of 24-28 weeks screened for GDM through Oral Glucose Tolerance test (OGTT) as per Diabetes In Pregnancy Study group in India (DIPSI) guideline, irrespective of fasting status. Findings: A total of 1212 pregnant women underwent the OGTT. Overall prevalence of GDM found to be 16.67%(CI=14.61-18.89%) in Assam. Bivariant regression (unadjusted) showed Age > 30 years (P=0.02), Overweight/ Obese (P=0.02), Above Poverty Line (APL) (P=0.01), Non-anemic (P=0.03), Family history of diabetes(P=0.00) had significant association with GDM. After multivariant regression analysis, we found that 10th pass pregnant women(P=0.03), Age group with 26-30 years (P=0.01), Muslim religion (P= 0.03), Current Smoking (P=0.01) and Family history of diabetes (P=0.02) had significant independent associations with GDM. Interpretation: The prevalence of gestational diabetes mellitus in low resource setting in rural Assam found to be quite high. MMUs can be utilised for screening for GDM in difficult-to-reach villages with proper guideline and sufficient resource allocation. Funding Statement: World Diabetes Foundation Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study had the approval of institutional ethics committee through letter no. PSMRI/2019/11 dated 11th May, 2019. In addition, study was also endorsed by Government of Assam. Written informed consent was taken from each participant.
Published Version
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