Strategic Interventions in the Management of Gestational Diabetes to Reduce Type 2 Diabetes Mellitus in Women in Malaysia

ABSTRACT

According to the Global status report on non-communicable diseases 2010, the prevalence of high blood sugars among adults exceeds 11 % in both males and females in Malaysia. This is the highest among ASEAN countries. This ties up closely with the prevalence of overweight adults in both sexes in the same report, again Malaysians rank highest among ASEAN countries. The burden of diabetes mellitus in Malaysia is estimated to be 12% of the population with a projected figure exceeding 15 % in 2020. 1 This enormous rise in both obesity and hyperglycaemia in adults is alarming and clear strategies to combat this noncommunicable disease is urgently warranted. One such strategy is to relook at the focussed approach of gestational diabetes mellitus (GDM) management currently in vogue in Malaysia, and suggest more effective preventive measures in view of information currently coming to light on both short and long term implications of GDM on both mother and offspring. Although information on actual prevalence of GDM in Malaysia is lacking, available crude data from hospital births obtained from the National Obstetric Register in 2010 involving 14 major government hospitals was 9.9% with Indians ranking highest followed by Malays and Chinese. Incidence of macrosomia in GDM mothers was double that of non-GDM mothers. A higher caesarean section rate with a threefold increase in shoulder dystocia was also recorded in those with GDM.