English

Abstract

BACKGROUND: Gestational diabetes mellitus (GDM) is a disorder of carbohydrate metabolism with grave consequences for both the mother and child. Numerous methodologies for the diagnosis of GDM have been proposed. We used the Diabetes in pregnancy study group India (DIPSI) procedure to diagnose GDM. The objectives of this study are to find out the incidence of gestational diabetes mellitus in pregnant women and their pregnancy outcomes in a rural setting. MATERIALS AND METHODS: It is a hospital based prospective study performed on 400 pregnant women between 24 to 28 weeks of gestation over a period of one year. All were given a 75 gms oral glucose load, irrespective of their last meal, and venous plasma glucose was estimated after 2 hours. Cases with 2 hours plasma glucose value ≥140 mg% were diagnosed as GDM. All GDM patients were followed up and treated with medical nutrition therapy (MNT) and/or insulin therapy till delivery to know the maternal and foetal outcomes. RESULTS: The incidence of GDM was 5.7 % using the DIPSI method. GDM was observed more frequently in age ≥25years (34.8%), BMI ≥25 (39.1%), past history of GDM (4.3%), family history (13%), history of previous pregnancy loss (13.8%), and history of polyhydramnios (8.7%). The foetal and maternal outcomes in GDM were: anencephaly (4.3%), gestational hypertension (8.7%), macrosomia (13.0%) and preterm delivery (17.4%). CONCLUSION: Women with GDM are at an increased risk for adverse obstetric and perinatal outcome. Screening the pregnant women for GDM and achieving euglycemia can prevent maternal and foetal complications. Hence, universal instead of selective screening should be mandatory. DIPSI procedure is a one step cost effective procedure for