Prevalence of gestational diabetes mellitus and its feto-maternal outcome in Kamla Nehru state hospital for mother and child, IGMC, Shimla, India

Abstract

Background: Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity with the onset or first recognition during pregnancy. It is a disease entity that adversely affects maternal as well as fetal outcome. DIPSI guideline having suggested one-time plasma glucose level has emerged as a simple, practical and cheap method to detect GDM. This study was done to evaluate the prevalence of gestational diabetes using Diabetes in Pregnancy Study Group India (DIPSI) criteria and further assess its feto maternal outcome in Kamla Nehru State Hospital for Mother and Child, IGMC, Shimla.Methods: This study was conducted in 500 patients between 24 and 28 weeks of gestation, attending the antenatal OPD. These patients were given 75g oral glucose irrespective of last meal and their plasma glucose was estimated at 2h. Patients with plasma glucose ≥140mg/dl were diagnosed as GDM and the rest as control or the non GDM group. The GDM patients were followed up and treated with medical nutrition therapy (MNT) and/or insulin therapy till delivery and maternal and fetal outcomes were then noted.Results: The prevalence of GDM in this study was 6%. Maternal and fetal complications were more in the GDM patients. Vaginal candidiasis and PROM were the common maternal complications, while hypoglycemia and hyperbilirubinemia were common in the fetuses.Conclusions: GDM adversely affects the mother as well as fetus. DIPSI guideline having suggested a single plasma glucose level test has emerged as a practical and economical method to detect GDM.