Detection and care of gestational diabetes mellitus in the present scenario

ABSTRACT

All efforts should be made in planning appropriate and possible methods of delivering health care for pregnant woman in the pandemic ocean of COVID-19,with limited medical facilities.Gestational Diabetes Mellitus (GDM) may play a crucial role in the increasing prevalence of diabetes and obesity and also may be the Origin of Cardio Metabolic Diseases. The Ministry of Health and Family Welfare, Government of India expects health care providers to screen all pregnant woman for glucose intolerance by a feasible, do able, economical and evidence-based test. “A Single Test Procedure” which is also followed by Diabetes in Pregnancy Study Group India. This test is ideal in the pandemic times.For a better perinatal outcome, the fasting plasma glucose (FPG) has to be maintained between 80 mg/dl (4.4 mmol/dl) and 90 mg/dl (5.0 mmol/dl) and 2hr Post Prandial Plasma Glucose (PPPG)110 mg/dl (6.1 mmol/dl) and 120 mg/ dl (6.7 mmol/dl) and mean plasma glucose 105 mg/dl (5.9 mmol/dl).Medical Nutrition Therapy (MNT) and life style modifications are recommended as an initial step to maintain normal maternal glucose, failing which insulin or Oral Hypoglycemic Agent (OHA) may be advised. Both small for gestational age and large for gestational age babies are prone to develop diabetes in the future. Hence, the aim in the treatment is to obtain newborn babies birth weight appropriate for gestational age of 2.5 to 3.5 kg.